Healthcare Delivery Research Program Communications Evaluation Survey

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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0642 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Healthcare Delivery Research Program Communications Evaluation Survey Form
1 HDRP Survey Survey.docx Form
HDRP Survey Fast Track Request.docx HDRP Survey Fast Track Request IC Document

Information Collection (IC) Details

IC Title:	Healthcare Delivery Research Program Communications Evaluation Survey	Agency IC Tracking Number:

IC Status: Unchanged

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	1	HDRP Survey	Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 500	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
HDRP Survey Fast Track Request	HDRP Survey Fast Track Request.docx	11/21/2017

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