MyMedicare.gov User Satisfaction Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (CMS-10415)

OMB: 0938-1185

IC ID: 227720

Information Collection (IC) Details

View Information Collection (IC)

MyMedicare.gov User Satisfaction Survey
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10415 MyMedicare.gov Survey CMS-10415.Fast Track Survey - MyMedicaregov.docx Yes Yes Fillable Fileable Signable

Health Health Care Services

 

6,000 0
   
Individuals or Households
 
   100 %

  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 6,000 0 6,000 0 0 0
Annual IC Time Burden (Hours) 200 0 200 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
CMS-10415.MyMedicare Survey - Clearance Template CMS-10415.MyMedicare Survey - Clearance Template.doc 07/26/2017
Supplemental Information Supplemental Info - MyMedicare.gov Survey.docx 12/26/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

© 2024 OMB.report | Privacy Policy