Customer Service Satisfaction Assessment of TB Laboratory Site Visits conducted by CDC Laboratory Consultants-Online Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NCHHSTP)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1027 can be found here:

Documents and Forms

Document Name Document Type
Customer Service Satisfaction Assessment of TB Laboratory Site Visits conducted by CDC Laboratory Consultants-Online Survey Form and Instruction
Appendix 1_Word Version_New Online Survey Instrument.docx Other-WORD version of instrument con
Site Visit Evaluation: Immediate Follow-up Appendix 2_Web Shots_New Online Survey.docx Form and Instruction
Generic Clearance Template-Customer Satisfaction Site Visit_Online_New.docx Completed 0920-1027 Template with Project Description IC Document
Service Delivery Checklist_Customer Satisfaction Site Visit.docx Completed checklist for submissions under 0920-1027 IC Document

Information Collection (IC) Details

IC Title:	Customer Service Satisfaction Assessment of TB Laboratory Site Visits conducted by CDC Laboratory Consultants-Online Survey	Agency IC Tracking Number:	0920-20ED

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	n/a	Site Visit Evaluation: Immediate Follow-up	Appendix 2_Web Shots_New Online Survey.docx		Yes	Yes	Fillable Fileable
Other-WORD version of instrument content to facilitate review of all possible questions			Appendix 1_Word Version_New Online Survey Instrument.docx		No		Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 58	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	58	58
Annual IC Time Burden (Hours)	10	10
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Completed 0920-1027 Template with Project Description	Generic Clearance Template-Customer Satisfaction Site Visit_Online_New.docx	12/18/2019
Completed checklist for submissions under 0920-1027	Service Delivery Checklist_Customer Satisfaction Site Visit.docx	12/18/2019

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