Information Collection

Health, United States Website User Customer Satisfaction Survey

IC 235848 under ICR 201707-0920-009 · OMB 0920-0729.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0729 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-0729 Health, United States Website User Customer Satisfaction Survey	Form and Instruction
0920-0729 Web User Survey Att A HUS Web User 040219.docx	Form and Instruction
0920-0729 Web User Popup Survey Att B HUS Web User Survey 040119.docx	Form and Instruction
HUS Sup St A 042219.docx SSA	IC Document
HUS Sup St B 042219.docx SSB	IC Document

IC Title:

Health, United States Website User Customer Satisfaction Survey

Agency IC Tracking Number:

0920-0729-19ASG

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
Form and Instruction	0920-0729	Web User Survey	Att A HUS Web User 040219.docx		Yes	Yes	Fillable Fileable
Form and Instruction	0920-0729	Web User Popup Survey	Att B HUS Web User Survey 040119.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,000	3,000
Annual IC Time Burden (Hours)	275	275
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA	HUS Sup St A 042219.docx	04/29/2019
SSB	HUS Sup St B 042219.docx	04/29/2019

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