Seasonal Flu: Email Updates Satisfaction Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1050 can be found here:

Documents and Forms

Document Name Document Type
Seasonal Flu: Email Updates Satisfaction Survey Form and Instruction
Flu Email Updates Survey C-SURVEY QUESTIONS_Flu Email Updates_08_08_2017 (002).docx Form and Instruction
B-INVITATION_Flu Email Updates_08_08_2017 (002).docx Invitation Email - Flu Email Updates IC Document
A-PROTOCOL_Flu Email Updates_08_08_2017 (002).docx Protocol - Flu Email Updates IC Document
Fast_Track_GenIC_Request_Flu Email Updates.docx GenIC Request - Flu Email Updates IC Document

Information Collection (IC) Details

IC Title:	Seasonal Flu: Email Updates Satisfaction Survey	Agency IC Tracking Number:	0920-1050-17BAX

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 and Instruction	NA	Flu Email Updates Survey	C-SURVEY QUESTIONS_Flu Email Updates_08_08_2017 (002).docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	8	8
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Invitation Email - Flu Email Updates	B-INVITATION_Flu Email Updates_08_08_2017 (002).docx	09/05/2017
Protocol - Flu Email Updates	A-PROTOCOL_Flu Email Updates_08_08_2017 (002).docx	09/05/2017
GenIC Request - Flu Email Updates	Fast_Track_GenIC_Request_Flu Email Updates.docx	09/05/2017

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