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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.