OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Medicare OMBudsman Customer Service Feedback Survey

IC 37921 under ICR 201512-0938-002 · OMB 0938-0894.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

MEDICARE OMBUDSMAN CUSTOMER SERVICE FEEDBACK SURVEY
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10068 Medicare Ombudsman Customer Service Feedback Survey CMS-10068 (0938-0894) 2016ProposedMedicareOmbudsmanCustomerServiceFeedbackSurveyFinal.docx No   Fillable Fileable Signable

Health Health Care Services

 

2,380 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 2,380 0 0 0 0 2,380
Annual IC Time Burden (Hours) 317 0 0 0 0 317
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.