2019 CT.gov Website Usability Survey (NLM)

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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Document Name Document Type
Form 1 2019 CT.gov Website Usability Survey (NLM) Form
1 NLM 2019 CT Usability Survey NLM 2019 CT Usability Survey Instrument.pdf Form
1 NLM 2019 CT Usability Survey NLM 2019 CT Usability Survey Instrument.pdf Form
NLM Fast Track ICR_2019 CT.gov Usability Survey.docx Fast track CIR 2019 CT.gov Usability survey IC Document
NLM Fast Track ICR_2019 CT.gov Usability Survey.docx Fast track CIR 2019 CT.gov Usability survey IC Document

Information Collection (IC) Details

IC Title:	2019 CT.gov Website Usability Survey (NLM)	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	NLM 2019 CT Usability Survey	NLM 2019 CT Usability Survey Instrument.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 110	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	110	110
Annual IC Time Burden (Hours)	18	18
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Fast track CIR 2019 CT.gov Usability survey	NLM Fast Track ICR_2019 CT.gov Usability Survey.docx	02/11/2019

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