Fast Track Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

ICR 201708-0990-001

OMB: 0990-0379

Federal Form Document

Forms and Documents
Document
Name
Status
Supplementary Document
2017-08-10
Supplementary Document
2017-08-10
Justification for No Material/Nonsubstantive Change
2015-03-03
Supporting Statement B
2014-07-02
Supporting Statement A
2017-08-11
Supplementary Document
2011-06-14
IC Document Collections
IC ID
Document
Title
Status
242385 New
241935 New
241507 New
241442 New
240556 New
238901 New
238886 New
238645 New
238640 New
237566 New
236685 New
236682 New
236677 New
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235921 New
235917 New
235834 New
235787 New
235786 New
235506 New
235505 New
234828 New
234739 New
233963 New
232651 New
232582 New
232576 New
231850 New
231844 New
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230637 New
229868 New
229756 New
229755 New
229754 New
229536 New
229535 New
228940 New
228504 New
228490 New
228489 New
ICR Details
0990-0379 201708-0990-001
Historical Active 201503-0990-001
HHS/HHSDM
Fast Track Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
Extension without change of a currently approved collection   No
Regular
Approved without change 09/25/2017
Retrieve Notice of Action (NOA) 08/11/2017
OMB approves this collection for a period of three years. To request approval of information collections under this generic approval, the agency must do the following: 1) Unless an agency is using multiple modes of collection (e.g., paper forms and electronic submissions), provide a Generic Clearance Submission Template for each Instrument; 2) If the agency is using multiple modes of collection (e.g., paper forms and electronic submissions), the same Generic Clearance Submission Template may be used for both instruments; 3) each Generic Clearance Submission Template must be uploaded as a Supplementary document using a naming convention that allows the public to identify the associated instrument; 4) submit no more than five Generic Submission Templates with each request.
  Inventory as of this Action Requested Previously Approved
09/30/2020 36 Months From Approved 09/30/2017
3,000,000 0 3,000,000
500,000 0 500,000
0 0 0
This collection of information is necessary to enable HHS to garner customer and stakeholder feedback in an efficient, timely manner, in accordance with our commitment to improving service delivery. The information collected from our customers and stakeholders will help ensure that users have an effective, efficient, and satisfying experience with HHS programs.
EO: EO 12862 Name/Subject of EO: Setting Customer Service Standards
  
None
Not associated with rulemaking
  82 FR 21392 05/08/2017
82 FR 34682 07/26/2017
No
46
IC Title Form No. Form Name
HRSA Health Workforce Connector (HWC) Satisfaction Survey
ASPR TRACIE Webinar Polling
Health IT Website Satisfaction Survey
Womenshealth.gov Homepage Redesign Testing
STEP Post Survey
Azalea Prevention Project
Peer Support and Pain Self-Management Education Program Feedback
Youth Listening Session Grantee Satisfaction Survey 2019
Office of Population Affairs (OPA) Title X Grantee Needs Assessment Survey
ODPHP Website Visitor Satisfaction Site- and Page-Level Surveys
PHE.gov Satisfaction Surveys: Exit Survey and In-Page Survey
Rowan University School of Osteopathic Medicine (SOM)
Request for feedback from Teen Pregnancy Prevention Program (TPP) Grantees on the technical assistance (TA) and training provided to them by the Office of Adolescent Health (OAH)
OWH Prevention Award - Provider Qualitative Interviews
Region IX Office of the Regional Health Administrator (ORHA) External Customer Satisfaction Survey
Promoting Older Women's Engagement in Recovery (POWER) Post Training Survey
Health and Human Services (HHS) Office of the Assistant Secretary for Health (OASH) Region 4, Raising Awareness of Human Trafficking Among School Personnel Training End-of-Course Evaluation
Adolescent SBIRT (A-SBIRT) Online Training (Kognito) Feedback Surveys
Promoting Older Women's Engagement in Recovery (POWER) Post Training Surveys
Tree Testing FDA.Gov
Join the Healthcare and Public Health (HPH) Risk Identification and Site Criticality (RISC) Toolkit Mailing List
Tree Testing for Grants.Gov
Office on Women's Health Youth Engagement in Sports (YES) Initiative Online Survey
HRSA Bureau of Health Workforce (BHW) Site Admin Portal Satisfaction Survey
HRSA In-Page Web Survey
Card Sort Online Data Collection for Grants.gov
Adolescent SBIRT (A-SBIRT) In-Person Training Feedback Surveys: a) Satisfaction and Retrospective Knowledge and Awareness Survey b) A-SBIRT 3 month/6 month Usage Feedback Survey(s)
Surveys for Building Your Wellness Toolbox (A six week psycho-educational group as part of the Promoting Older Women's Engagement in Recovery project)
www.medicalcountermeasures.gov customer site feedback form
Office of Adolescent Health Annual Grantee Satisfaction Survey
Home Health and Hospice Survey and Interviews
OWH Prevention Award - SBIRT Provider Knowledge and Confidence Survey
Promoting Older Women's Engagement in Recovery (POWER) Seeking Safety Training Survey
Surveys to Inform Service Delivery Improvement of Teen Intervene Curriculum with Mental Health Providers and Adolescent Clients
Qualitative Research for Medical Community Baselining Phase II
Comments on the Cybersecurity in the healthcare and public health sector
OWHPA Grantee Cross-Site Evaluation
Office of Adolescent Health Grantee Group Training and Technical Assistance Satisfaction Survey
Office of Adolescent Health Individual Technical Assistance Grantee Satisfaction Surveys
STEP Pre Survey
Feedback onTopics of Interest for the Provision of technical assistance for Teen Pregnancy Prevention Program Grantees in FY2019
Bureau of Health Workforce (BHW) Website Card Sort
HRSA Web Survey for Bureau of Health Workforce (BHW) program participants
Office of Population Affairs Teen Pregnancy Prevention and Pregnancy Assistance Fund Grantee Satisfaction Survey
FDA.gov Card Sort Online Survey
HealthIT.gov Website Satisfaction Survey
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 3,000,000 3,000,000 0 0 0 0
Annual Time Burden (Hours) 500,000 500,000 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$250,000
Yes Part B of Supporting Statement
    No
    No
No
No
No
Uncollected
Sherrette Funn-Coleman 2026905683
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
08/11/2017
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