30724 2021 Medicaid.gov Feedback Survey

E-Government Website Customer Satisfaction Surveys

OMB: 1090-0008

IC ID: 250369

Information Collection (IC) Details

View Information Collection (IC)

30724 2021 Medicaid.gov Feedback Survey 30724
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 30724 30724 2021 Medicaid.gov Feedback Survey 30724 2021 Medicaid.gov Feedback Survey.xlsx Yes Yes Fillable Fileable

General Government Central Records & Statistical Mgt

 

1,300 0
   
Individuals or Households
 
   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 1,300 0 1,300 0 0 0
Annual IC Time Burden (Hours) 22 0 22 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
1090-0008 Generic Clearance Request - Medicaid.gov Feedback survey Fall 2021_signed Jayne Hammen 1090-0008 Generic Clearance Request - Medicaid.gov Feedback survey Fall 2021_signed Jayne Hammen.pdf 11/16/2021
1090-0008 Survey Mapping Doc Medicaid.gov Feedback survey 1090-0008 Survey Mapping Doc Medicaid.gov Feedback survey.docx 11/16/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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