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Customer Feedback Survey
Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration
OMB: 0915-0212
IC ID: 260381
OMB.report
HHS/HSA
OMB 0915-0212
ICR 202312-0915-001
IC 260381
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0212 can be found here:
2024-01-10 - Revision of a currently approved collection
2024-01-04 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form 1
Customer Feedback Survey
Form and Instruction
1 Customer Feedback Survey
BPHC Customer Feedback Survey.final.docx
Form and Instruction
Fast track Memo_May.docx
Customer Feedback Fast Track
IC Document
Information Collection (IC) Details
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