Clinical Contact Center Survey

Clearance for A-11 Section 280 Improving Customer Experience Information Collection

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0876 can be found here:

Documents and Forms

Document Name Document Type
Form 2020-2900-0876-R1 Clinical Contact Center Survey Form and Instruction
2020-2900-0876-R1 Clinical Contact Center Survey ECCC_Survey and Emails_V5_061620.pdf Form and Instruction
Sample Plan Clinical Contact Centers.docx Survey Sample Methodology IC Document
A-11 Fast-Track Clearance Request Template_Clinical Call Centers_(005).pdf A-11 Requirements Document IC Document

Information Collection (IC) Details

IC Title:	Clinical Contact Center Survey	Agency IC Tracking Number:	2020-2900-0876-R

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	2020-2900-0876-R1	Clinical Contact Center Survey	ECCC_Survey and Emails_V5_061620.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 8,688	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	8,688	8,688
Annual IC Time Burden (Hours)	434	434
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Survey Sample Methodology	Sample Plan Clinical Contact Centers.docx	06/26/2020
A-11 Requirements Document	A-11 Fast-Track Clearance Request Template_Clinical Call Centers_(005).pdf	06/26/2020

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