Center for Clinical Standards and Quality (CCSQ) Support Central Customer Satisfaction Survey (CMS-10818)

Generic Clearance for the Center for Clinical Standards and Quality IT Product and Support Teams (CMS-10706)

Documents and Forms

Document Name Document Type
Form CMS-10818 Center for Clinical Standards and Quality (CCSQ) Support Central Customer Satisfaction Survey (CMS-10818) Form and Instruction
CMS-10818 Call Scheduling CMS-10818 Call Scheduling - CCSQ Suppot Central Survey Mock-ups.pdf Form and Instruction
CMS-10818 Call Scheduling CMS-10818 Call Scheduling - CCSQ Suppot Central Survey Mock-ups.pdf Form and Instruction
CMS-10818 Create A Ticket CMS-10818 Create A Ticket - CCSQ Support Central Survey Mock-ups.pdf Form and Instruction
CMS-10818 Create A Ticket CMS-10818 Create A Ticket - CCSQ Support Central Survey Mock-ups.pdf Form and Instruction
CMS-10818 Live Chat CMS-10818 Live Chat - CCSQ Support Central Survey Mock-ups.pdf Form and Instruction
CMS-10818 Live Chat CMS-10818 Live Chat - CCSQ Support Central Survey Mock-ups.pdf Form and Instruction
CMS-10818 Track Existing Ticket CMS-10818 Track Existing Ticket - CCSQ Support Central Survey Mock-ups.pdf Form and Instruction
CMS-10818 Track Existing Ticket CMS-10818 Track Existing Ticket - CCSQ Support Central Survey Mock-ups.pdf Form and Instruction
CMS-10818 CCSQ Support Central Surveys Supporting Statement.docx Supporting Statement IC Document
CMS-10818 CCSQ Support Central Surveys Supporting Statement.docx Supporting Statement IC Document

Information Collection (IC) Details

IC Title:	Center for Clinical Standards and Quality (CCSQ) Support Central Customer Satisfaction Survey (CMS-10818)	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10818	Call Scheduling	CMS-10818 Call Scheduling - CCSQ Suppot Central Survey Mock-ups.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	CMS-10818	Create A Ticket	CMS-10818 Create A Ticket - CCSQ Support Central Survey Mock-ups.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	CMS-10818	Live Chat	CMS-10818 Live Chat - CCSQ Support Central Survey Mock-ups.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	CMS-10818	Track Existing Ticket	CMS-10818 Track Existing Ticket - CCSQ Support Central Survey Mock-ups.pdf	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,800	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,800	2,800
Annual IC Time Burden (Hours)	93	93
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement	CMS-10818 CCSQ Support Central Surveys Supporting Statement.docx	05/09/2024

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