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Federal forms, ICRs, and supporting documents

Information Collection

Whiteriver Service Unit (WRSU) Birthing Center Patient Satisfaction Survey

IC 250081 under ICR 202201-0917-001 · OMB 0917-0036.

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

View Information Collection (IC)

Whiteriver Service Unit (WRSU) Birthing Center Patient Satisfaction Survey
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0917-0036 Whiteriver Service Unit (WRSU) Birthing Center Patient Satisfaction Survey Survey Questions_IHS-WRSU Birthing Center Patient Satisfaction Survey.docx No   Paper Only

Health Health Care Services

 

50 0
   
Individuals or Households
 
   0 %

  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 50 0 0 0 0 50
Annual IC Time Burden (Hours) 4 0 0 0 0 4
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Whiteriver Service Unit (WRSU) Birthing Center Patient Satisfaction Survey IHS-WRSU Birthing Center Patient Satisfaction Survey.docx 11/03/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.