OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Voluntary Customer Satisfaction Survey of AHRQ PSNet Users

IC 252763 under ICR 202501-0935-001 · OMB 0935-0179.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Voluntary Customer Satisfaction Survey of AHRQ PSNet Users
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Usability Script Usability Scriptv2.docx Yes Yes Fillable Fileable
Form and Instruction 2 Web Screener Survey Web Screener Questionsv1.docx Yes Yes Fillable Fileable

Health Health Care Services

 

225 0
   
Individuals or Households
 
   100 %

  Requested 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 225 0 0 0 0 225
Annual IC Time Burden (Hours) 35 0 0 0 0 35
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Cover Letter OMB Cover Letter.docx 04/08/2022
Supporting Statement Submission Form-2022-PSNet_V2.docx 04/21/2022
Consent form Usability Consent Form.docx 04/08/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.