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Telephone Clients Demographic & Customer Satisfaction Questions
Collection of Customer Service, Demographic and Smoking/Tobacco Use Information from NCI's Contact Center, Cancer Information Service (CIS) Clients (NCI)
OMB: 0925-0208
IC ID: 219409
OMB.report
HHS/NIH
OMB 0925-0208
ICR 202201-0925-001
IC 219409
( )
Documents and Forms
Document Name
Document Type
Form 2
Telephone Clients Demographic & Customer Satisfaction Questions
Form and Instruction
2 Customer Service and Demographic Questions
Appendix 1A Customer Service and Demographic Questions_updated AG.docx
Form and Instruction
2 Customer Service and Demographic Questions
Appendix 1A Customer Service and Demographic Questions_updated AG.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Telephone Clients Demographic & Customer Satisfaction Questions
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Removed
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 and Instruction
2
Customer Service and Demographic Questions
Appendix 1A Customer Service and Demographic Questions_updated AG.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:
13,100
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
0
0
-13,100
0
0
13,100
Annual IC Time Burden (Hours)
0
0
-437
0
0
437
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.