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Federal forms, ICRs, and supporting documents

Information Collection

HRSA Electronic Handbooks Customer Service Survey

IC 264346 under ICR 202401-0915-004 · OMB 0915-0212.

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)

HRSA Electronic Handbooks Customer Service Survey
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 EHB Customer Support Center Survey Screenshot EHBs Customer Support Center Survey Screenshot.docx Yes Yes Fillable Fileable

Health Health Care Services

 

5,000 0
   
Individuals or Households
 
   100 %

  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 5,000 0 5,000 0 0 0
Annual IC Time Burden (Hours) 40 0 40 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Original Generic Request HRSA EHBs Survey Supporting Statement draft 020221.docx 01/09/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.