EOHSI/Rutgers Clinical Center of Excellence Annual Monitoring Exam Patient Satisfaction Survey

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

OMB: 0920-0953

IC ID: 236603

Information Collection (IC) Details

View Information Collection (IC)

EOHSI/Rutgers Clinical Center of Excellence Annual Monitoring Exam Patient Satisfaction Survey 0920-0953-19BIA
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-0953 Rutgers Patient Satisfaction Survey 2019 Rutgers Patient Satisfaction Survey 2019.pdf No   Fillable Fileable

Health Health Care Services

 

2,100 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 2,100 0 2,100 0 0 0
Annual IC Time Burden (Hours) 175 0 175 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Fasttrack Submission Template OMB Fast Track Submission__Rugters_061819.docx 06/21/2019
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