Information Collection

National Diabetes Prevention Program Customer Service Center (National DPP CSC) -- Customer Satisfactory Surveys

IC 231398 under ICR 201605-0920-001 · OMB 0920-1050.

⚠️ Notice: This information collection may be referencing outdated material.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
Form 0920-1050 National Diabetes Prevention Program Customer Service Center (National DPP CSC) -- Customer Satisfactory Surveys Form and Instruction
0920-1050 National DDP Customer Service Center -- Surveys Along th Att 5. - National DPP Customer Service Center - Surveys.pptx Form and Instruction
Att 1. - Fast_Track_Cust Sat_National DPP CSC.DOCX Request for Approval IC Document
Att 3. - Supporting-Statement-Part_A_National DPP CSC Customer Satisfaction.docx Supporting Statement A IC Document
Att 4. - Supporting-Statement-Part_B_National DPP CSC Customer Satisfaction.docx Supporting Statement B IC Document
Att 6. - 684 Form.pdf IRB Approval IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	National Diabetes Prevention Program Customer Service Center (National DPP CSC) -- Customer Satisfactory Surveys	Agency IC Tracking Number:	0920-1050 (18AFG)

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	0920-1050	National DDP Customer Service Center -- Surveys Along the Customer Journey	Att 5. - National DPP Customer Service Center - Surveys.pptx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,000	3,000
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Request for Approval	Att 1. - Fast_Track_Cust Sat_National DPP CSC.DOCX	05/09/2018
Supporting Statement A	Att 3. - Supporting-Statement-Part_A_National DPP CSC Customer Satisfaction.docx	05/09/2018
Supporting Statement B	Att 4. - Supporting-Statement-Part_B_National DPP CSC Customer Satisfaction.docx	05/09/2018
IRB Approval	Att 6. - 684 Form.pdf	05/09/2018

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