[NCEZID] HHS Protect User Satisfaction Survey

[NCEZID] Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1071 can be found here:

Documents and Forms

Document Name Document Type
[NCEZID] HHS Protect User Satisfaction Survey Form and Instruction
[NCEZID] HHS Protect User Satisfaction Survey Form and Instruction
External User Satisfaction Survey for HHS Protect Users External User Satisfaction Survey for HHS Protect Users.pdf Form and Instruction
External User Satisfaction Survey for HHS Protect Users External User Satisfaction Survey for HHS Protect Users.pdf Form and Instruction
HHS Protect User Survey External Email Language_final.docx Survey Email Invite IC Document
HHS Protect User Survey External Email Language_final.docx Survey Email Invite IC Document
Human Subjects Determination.pdf Human Subjects Determination IC Document
Human Subjects Determination.pdf Human Subjects Determination IC Document
Service Delivery Fast Track Template_HHS Protect Survey.docx GenIC Request Template IC Document
Service Delivery Fast Track Template_HHS Protect Survey.docx GenIC Request Template IC Document

Information Collection (IC) Details

IC Title:	[NCEZID] HHS Protect User Satisfaction Survey	Agency IC Tracking Number:	0920-1071-23GS

IC Status: Unchanged

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
Form and Instruction	n/a	External User Satisfaction Survey for HHS Protect Users	External User Satisfaction Survey for HHS Protect Users.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 500	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	83	83
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Survey Email Invite	HHS Protect User Survey External Email Language_final.docx	07/11/2023
Human Subjects Determination	Human Subjects Determination.pdf	07/11/2023
GenIC Request Template	Service Delivery Fast Track Template_HHS Protect Survey.docx	07/11/2023

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