HC3 Customer Feedback Form

Fast Track Generic Clearance for the Collection of Routine Customer Feedback - HHS Communication

0990-0459 HC3 Customer Feedback Form 05_28

HC3 Customer Feedback Form

OMB: 0990-0459

Document [pdf]
Download: pdf | pdf
Form Approved
OMB No. 0990-0459
Exp. Date 09/30/2020

HC3| Customer Feedback Survey

Health Sector Cybersecurity Coordination Center (HC3) | [email protected]

Product Name

Product ID:

All survey responses are combined and summarized in a report to protect your anonymity.

Organization Type: Information Sharing/Analysis Organizations

Size

Academic/University
Ambulatory
Doctor's
Association
GovernmentHealthcare
HospitalNursing
Manfacturers/Distributors
Insurance/Plan/Provider
Services
Pharma
Other
Urgent
Telehealth
Care
Home
(Managed
Office
Community
Integrated
Large
Rural
Payer
Surgical
Clinic
Federal
Health
Military
State/Local
Services
Delivery
Center
Medical
HealthProvider,
Network
Center Legal, Consulting, Retirement
Community, etc.)
Large
Medium
Small

1. Please rate your satisfaction with each of the following: (Check one per row)
Very
Satisfied

Somewhat
Satisfied

Neither
Satisfied nor
Dissatisfied

Very
Dissatisfied

N/A

Overall Usefulness
Relevance to Mission
Timeliness
2. How do you plan to use this product in support of your mission? (Check all that apply)
Share With Leadership to Drive Decisions

Adjust Policies and Procedures

Allocate Resources

Education / Training

Share With Partners

Develop Internal Analysis

3. What topics are you interested in hearing about? (Check all that apply)
Ransomware/Malware Types

Disaster Recovery

Data Breech Issues
Supply Chain Issues
Risk Management/ Cyber Hygiene

Threat Actors/Threat Actor Types
Healthcare Cybersecurity Legislative and Regulatory
Issues
Cutting Edge/Future Technology Impacting Healthcare
Cybersecurity

4. Do you have any additional comments or topics of interest?

Submit Form
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is
0990-0459. The time required to complete this information collection is estimated to average 10 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, to review and
complete the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Health & Human Services, OS/OCIO/PRA, 200
Independence Ave., S.W., Suite 336-E, Washington D.C. 20201, Attention: PRA Reports Clearance Officer


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File Modified2020-05-28
File Created2020-05-14

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