Patient Experience Informal Interviews

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

OMB: 0704-0553

IC ID: 275179

Documents and Forms
Document Name
Document Type
Other-Interview Questions
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Patient Experience Informal Interviews
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Interview Questions 0704-0553_Patient Experience Informal Interviews.docx No   Paper Only

Defense and National Security Operational Defense

 

75 0
   
Individuals or Households
 
   0 %

  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 75 0 0 0 0 75
Annual IC Time Burden (Hours) 13 0 0 0 0 13
Annual IC Cost Burden (Dollars) 394 0 0 0 0 394

Title Document Date Uploaded
One Pager Justification 0704-0553_OnePager_Patient Experience Interviews_5.6.2025.docx 05/06/2025
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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