TRICARE Inpatient Satisfaction Survey (Child)

TRICARE Inpatient Satisfaction Survey (TRISS)

Documents and Forms

Document Name Document Type
TRISS Child Survey.docx Other-Survey
TRISS Child Survey.docx Other-Survey

Information Collection (IC) Details

IC Title:	TRICARE Inpatient Satisfaction Survey (Child)	Agency IC Tracking Number:	0720-TRSS

Is this a Common Form? No		IC Status: New

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
Other-Survey			TRISS Child Survey.docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	3,000	3,000
Annual IC Time Burden (Hours)	750	750
Annual IC Cost Burden (Dollars)	22,320	22,320

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.