Patient Perception Survey- Non-Behavioral (CC)

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

OMB: 0925-0648

IC ID: 246551

Information Collection (IC) Details

View Information Collection (IC)

Patient Perception Survey- Non-Behavioral (CC)
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 1 Adult and Pediatric Outpatient Services Survey Adult and Pediatric Outpatient Services Survey.docx Yes Yes Fillable Fileable
Form 2 Adult and Pediatric Outpatient Survey Adult and Pediatric Outpatient Survey.docx Yes Yes Fillable Fileable

Health Health Care Services

 

12,900 0
   
Individuals or Households
 
   100 %

  Requested 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 51,600 0 51,600 0 0 0
Annual IC Time Burden (Hours) 4,300 0 4,300 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Patient Perception Survey- Non-Behavioral (CC) Fast track request for CC Patient Perception Survey Non-Behavioral.docx 04/01/2021
Introductory email-Logon-Welcome Message Introductory Email-Login-Welcome Message (1).docx 04/01/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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