Information Collection

DMID Order-It Customer Satisfaction Survey (Private sector)

IC 233006 under ICR 201512-0925-005 · OMB 0925-0668.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0668 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 DMID Order-It Customer Satisfaction Survey (Private sector)	Form
1 Order It Survey Order It Survey.docx	Form
Fast Track Template 2017 DMID Order-It Private Sector (002).doc Fast Track Template DMID Order-It (Private Sector)	IC Document

IC Title:

DMID Order-It Customer Satisfaction Survey (Private sector)

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	Order It Survey	Order It Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 432

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	432	432
Annual IC Time Burden (Hours)	72	72
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast Track Template DMID Order-It (Private Sector)	Fast Track Template 2017 DMID Order-It Private Sector (002).doc	09/13/2018

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.