CureTB Partner Feedback (Satisfaction Assessment) Questionnaire 1

[NCEZID] Information Collection for Tuberculosis Data from Referring Entities to CureTB

OMB: 0920-1186

IC ID: 252223

Documents and Forms
Document Name
Document Type
Form and Instruction
Other-Questionnaire annotated with s
Other-Questionnaire annotated with s
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

CureTB Partner Feedback (Satisfaction Assessment) Questionnaire 1 0920-1186
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1186 CureTB Partner Feedback Att. F- Questionnaire 1 - Online Survey Preview-no skip logic.pdf Yes Yes Fillable Fileable
Other-Questionnaire annotated with skip logic Attachment A1.a. – Supplemental CureTB Program Partner Satisfaction Assessment Questionnaire 1.pdf No   Paper Only

Health Public Health Monitoring

 

100 0
   
State, Local, and Tribal Governments
 
   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 100 0 0 0 0 100
Annual IC Time Burden (Hours) 17 0 0 0 0 17
Annual IC Cost Burden (Dollars) 0 0 -743 0 0 743

Title Document Date Uploaded
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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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