Nurse Advice Line Patient Experience Survey

Fast Track Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

Documents and Forms

Document Name Document Type
Nurse Advice Line Survey.docx Other-Survey
One Pager Justification.docx One Pager Justification IC Document

Information Collection (IC) Details

IC Title:	Nurse Advice Line Patient Experience Survey	Agency IC Tracking Number:

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
Other-Survey			Nurse Advice Line Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,860	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	4,860	4,860
Annual IC Time Burden (Hours)	405	405
Annual IC Cost Burden (Dollars)	12,749	12,749

Documents for IC

Title	Document	Date Uploaded
One Pager Justification	One Pager Justification.docx	11/07/2024

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