Information Collection

Assessing Customer Satisfaction with Health, US Report

IC 233474 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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
OMB 0920_1050 GenIC Interview Guide Health US Report Federal Gov 20181012.docx	Other-Interview guide
Project Determination for ICatalyst.pdf Non-research detemination	IC Document
OMB 0920_1050 GenIC Clearance Request Health US Report Federal Gov 20181012.docx Request for Approval	IC Document

IC Title:

Assessing Customer Satisfaction with Health, US Report

Agency IC Tracking Number:

0920-1050-19AU

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
Other-Interview guide			OMB 0920_1050 GenIC Interview Guide Health US Report Federal Gov 20181012.docx		No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 50

Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Non-research detemination	Project Determination for ICatalyst.pdf	10/11/2018
Request for Approval	OMB 0920_1050 GenIC Clearance Request Health US Report Federal Gov 20181012.docx	10/15/2018

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