Information Collection

Children's Health Exposure Assessment Resource (CHEAR) Client Satisfaction Survey (NIEHS)

IC 234703 under ICR 202104-0925-001 · OMB 0925-0648.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Children's Health Exposure Assessment Resource (CHEAR) Client Satisfaction Survey (NIEHS)	Form
1 CHEAR Client Satisfaction survey CHEAR Client Satisfaction Survey 2019.pdf	Form
1 CHEAR Client Satisfaction survey CHEAR Client Satisfaction Survey 2019.pdf	Form
NIEHS CHEAR 2019 Client Satisfaction Survey Fast Track Template 2015.doc Fast track CHEAR Client Satisfaction Survey 2019	IC Document
NIEHS CHEAR 2019 Client Satisfaction Survey Fast Track Template 2015.doc Fast track CHEAR Client Satisfaction Survey 2019	IC Document

IC Title:

Children's Health Exposure Assessment Resource (CHEAR) Client Satisfaction Survey (NIEHS)

Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	CHEAR Client Satisfaction survey	CHEAR Client Satisfaction Survey 2019.pdf		No		Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 75

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	75	75
Annual IC Time Burden (Hours)	19	19
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast track CHEAR Client Satisfaction Survey 2019	NIEHS CHEAR 2019 Client Satisfaction Survey Fast Track Template 2015.doc	01/10/2019

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