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Benchmark & Follow-Up Web Survey – HCP Audience
Federal COVID Response - Audience Feedback to Inform Ongoing Messaging and Strategies for "Combat COVID" (OD)
OMB: 0925-0769
IC ID: 247689
OMB.report
HHS/NIH
OMB 0925-0769
ICR 202111-0925-006
IC 247689
( )
Documents and Forms
Document Name
Document Type
Form 6
Benchmark & Follow-Up Web Survey – HCP Audience
Form
6 Custom Web Survey with Consumer and Provider Paths
Updated Attachment 6 - Custom Web Survey with Consumer and Provider Paths_clean 110821.docx
Form
6 Custom Web Survey with Consumer and Provider Paths
Updated Attachment 6 - Custom Web Survey with Consumer and Provider Paths_clean 110821.docx
Form
Federal COVID Response 0925-0769 - HCP Suppl Materials.pptx
Federal COVID Response HCP Suppl Materials
IC Document
Federal COVID Response 0925-0769 - HCP Suppl Materials.pptx
Federal COVID Response HCP Suppl Materials
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Benchmark & Follow-Up Web Survey – HCP Audience
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
6
Custom Web Survey with Consumer and Provider Paths
Updated Attachment 6 - Custom Web Survey with Consumer and Provider Paths_clean 110821.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
300
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
1,500
0
0
0
0
1,500
Annual IC Time Burden (Hours)
375
0
0
0
0
375
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Federal COVID Response HCP Suppl Materials
Federal COVID Response 0925-0769 - HCP Suppl Materials.pptx
11/23/2021
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.