NCI Explore On Site (EXPOSE) Pre-and Post- Customer 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⚠️ Notice: This information collection may be referencing outdated material.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 0925-0642 can be found here:

Documents and Forms

Document Name Document Type
Form 1 NCI Explore On Site (EXPOSE) Pre-and Post- Customer Satisfaction Survey Form and Instruction
1 EXPOSE PRE-SURVEY EXPOSE pre-survey_final.pdf Form and Instruction
1 EXPOSE POST SURVEY EXPOSE post-survey_final.pdf Form and Instruction
EXPOSE Surveys Fast Track 070318_final.docx EXPOSE Survey Fast Track IC Document

Information Collection (IC) Details

IC Title:	NCI Explore On Site (EXPOSE) Pre-and Post- Customer Satisfaction Survey	Agency IC Tracking Number:

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	1	EXPOSE PRE-SURVEY	EXPOSE pre-survey_final.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	1	EXPOSE POST SURVEY	EXPOSE post-survey_final.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 40	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	40	40
Annual IC Time Burden (Hours)	7	7
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
EXPOSE Survey Fast Track	EXPOSE Surveys Fast Track 070318_final.docx	07/10/2018

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