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Collection of Qualitative Feedback on Telehealth.HHS.gov
Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration
OMB: 0906-0084
IC ID: 265626
OMB.report
HHS/HRSA
OMB 0906-0084
ICR 202402-0906-004
IC 265626
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0906-0084 can be found here:
2024-06-28 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form 1
Collection of Qualitative Feedback on Telehealth.HHS.gov
Form
1 Website user (page-level survey)
Telehealth Website - Page Level - SurveyEngSpan.docx
Form
2 Website user (site-wide survey)
Telehealth Website - Site Level - Survey EngSpan.docx
Form
Public Burden Statement.docx
Public Burden Statement Draft
IC Document
Telehealth Website - Fast Track Memo 2.15.24 FINAL.docx
Generic IC Memo
IC Document
Information Collection (IC) Details
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