Feedback Survey

Assisted Reproductive Technology (ART) Program Reporting System

OMB: 0920-0556

IC ID: 203355

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Feedback Survey
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a NASS Clinic Feedback Survey Att C4. Clinic Feedback Survey.pdf Yes Yes Fillable Fileable

Health Health Care Services

09-20-0136, Epidemiologic Studies and Surveillance of Disease Problems  57 FR 62812

255 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Approved 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 255 0 -93 0 0 348
Annual IC Time Burden (Hours) 9 0 -3 0 0 12
Annual IC Cost Burden (Dollars) 391 0 391 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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