Information Collection

GenIC #11: CMS Consumer Research on Websites and Tools

IC 269729 under ICR 202407-0938-019 · OMB 0938-1247.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-10437.GenIC#11 GenIC #11: CMS Consumer Research on Websites and Tools	Form and Instruction
CMS-10437.GenIC#11 CMS-10437.GenIC#11.WebToolsResearch_Instrument_FINAL CMS-10437.GenIC#11.WebToolsResearch_Instrument_FINAL.docx	Form and Instruction
CMS-10437.GenIC#11 CMS-10437.GenIC#11.WebToolsResearch_Instrument_FINAL CMS-10437.GenIC#11.WebToolsResearch_Instrument_FINAL.docx	Form and Instruction
CMS-10437.GenIC#11 - WebToolsResearch_SupportingStatement_FINAL.docx CMS-10437.GenIC#11 - WebToolsResearch_SupportingStatement_FINAL	IC Document
CMS-10437.GenIC#11 - WebToolsResearch_SupportingStatement_FINAL.docx CMS-10437.GenIC#11 - WebToolsResearch_SupportingStatement_FINAL	IC Document
CMS-10437.Justification for Providing Incentives for Participation in Marketing Research_Consumer Qualitative Research (1).docx CMS-10437.Justification for Providing Incentives for Participation in Marketing Research_Consumer Qualitative Research (1)	IC Document
CMS-10437.Justification for Providing Incentives for Participation in Marketing Research_Consumer Qualitative Research (1).docx CMS-10437.Justification for Providing Incentives for Participation in Marketing Research_Consumer Qualitative Research (1)	IC Document

IC Title:

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10437.GenIC#11	CMS-10437.GenIC#11.WebToolsResearch_Instrument_FINAL	CMS-10437.GenIC#11.WebToolsResearch_Instrument_FINAL.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 200

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	200	200
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
CMS-10437.GenIC#11 - WebToolsResearch_SupportingStatement_FINAL	CMS-10437.GenIC#11 - WebToolsResearch_SupportingStatement_FINAL.docx	08/06/2024
CMS-10437.Justification for Providing Incentives for Participation in Marketing Research_Consumer Qualitative Research (1)	CMS-10437.Justification for Providing Incentives for Participation in Marketing Research_Consumer Qualitative Research (1).docx	08/06/2024

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