OMB control number

Collection of Customer Service, Demographic and Smoking/Tobacco Use Information from NCI's Contact Center, Cancer Information Service (CIS) Clients (NCI)

OMB 0925-0208 · HHS/NIH.

OMB 0925-0208

This is an information collection request for a reinstatement with change for three years. NCI’s Cancer Information Service (CIS) currently collects demographic, customer service, and smoking cessation information from clients contacting the CIS by telephone, email, and through LiveHelp (an online instant messaging service). Information is collected to properly plan, implement, and evaluate cancer education efforts and provide smoking cessation services tailored to the individual client’s needs. Since its inception in 1976, the CIS has handled approximately 12 million calls from the public. The potential universe of the Cancer Information Service (CIS) clients is almost 262 million respondents based on the U.S. Census estimate for 2023 of adults who are 18 years and older. Changes to this submission include 3 updated Appendices to include the new SPD 15 guidelines and 1 Appendix update to include three new questions.

The latest form for Collection of Customer Service, Demographic and Smoking/Tobacco Use Information from NCI's Contact Center, Cancer Information Service (CIS) Clients (NCI) expires 2028-07-31 and is listed under ICR 202504-0925-001.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Form 1 Cancer Information Call Backs	Form
Form 1 Cancer Info Call Backs	Form
Form 1 VA Call Backs	Form
Form 1 VA Calls Backs	Form
Form 1 Email Intake Form	Form
Form 1 E-mail Intake form	Form
Form 1 Live Help Questions	Form
Form 1 LiveHelp Questions	Form
Form 1 Smoking Call Back Task	Form
Form 1 VA Smoking Cessation	Form
Form 1 Customer Service and Demographic Questions	Form
Form 1 Demographic & Customer Satisfaction Questions (App. 9)	Form
Form 1 Smoking Cessation Intake Questions	Form
Form 1 Smoking Cessation "Intake" Questions	Form
Form 1AB Customer Service and Demographic Questions	Form
Form 1A Customer Service and Demographic Questions	Form
Form 1A Demographic & Customer Satisfaction Questions (App.1A or 1 AB)	Form
Appendix 11 Public Comments for 60-Day FRN.docx	Supplementary Document
Appendix 11 Public Comments for 60-Day FRN.docx	Supplementary Document
Appendix 10 Electronic Contact Record Form and Screen Shots.docx	Supplementary Document
Appendix 10 Electronic Contact Record Form and Screen Shots.docx	Supplementary Document
Appendix 9 Customer Satisfaction Survey Questions.docx	Supplementary Document
Appendix 9 Customer Satisfaction Survey Questions.docx	Supplementary Document
Appendix 8 CC Annual Data Report.docx	Supplementary Document
Appendix 8 CC Annual Data Report.docx	Supplementary Document
Appendix 7 Confidentiality of Communications Policy.docx	Supplementary Document
Appendix 7 Confidentiality of Communications Policy.docx	Supplementary Document
Appendix 6 Office of Human Subject Research Not Applicable.docx	Supplementary Document
Appendix 6 Office of Human Subject Research Not Applicable.docx	Supplementary Document
Appendix 5 Privacy Act Memo.pdf	Supplementary Document
Appendix 5 Privacy Act Memo.pdf	Supplementary Document
Appendix 4 PIA 10.31.2024_modified.pdf	Supplementary Document
Appendix 4 PIA 10.31.2024_modified.pdf	Supplementary Document
Appendix 3 Social Media.docx	Supplementary Document
Appendix 3 Social Media.docx	Supplementary Document
0208 30-Day Published FRN.pdf	Supplementary Document
0208 30-Day Published FRN.pdf	Supplementary Document
SSA CIS 2025 FINAL - 4.10.2025.docx	Supporting Statement A
SSA CIS 2025 FINAL - 4.10.2025.docx	Supporting Statement A
Cancer Info Call Backs	Form
Cancer Info Call Backs	Form
VA Calls Backs	Form
VA Calls Backs	Form
E-mail Intake form	Form
E-mail Intake form	Form
LiveHelp Questions	Form
LiveHelp Questions	Form
VA Smoking Cessation	Form
VA Smoking Cessation	Form
Demographic & Customer Satisfaction Questions (App. 9)	Form
Demographic & Customer Satisfaction Questions (App. 9)	Form
Smoking Cessation "Intake" Questions	Form
Smoking Cessation "Intake" Questions	Form
Demographic & Customer Satisfaction Questions (App.1A or 1 AB)	Form
Demographic & Customer Satisfaction Questions (App.1A or 1 AB)	Form
Demographic & Customer Satisfaction Questions (App.1A or 1 AB)	Form

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Action
202504-0925-001	Reinstatement with change of a previously approved collection	2025-05-28
202201-0925-001	Revision of a currently approved collection	2022-01-11	Approved without change
201807-0925-001	Revision of a currently approved collection	2018-08-14	Approved without change
201512-0925-003	Revision of a currently approved collection	2015-12-28	Approved with change
201210-0925-004	Revision of a currently approved collection	2012-10-31	Approved with change
201208-0925-003	Revision of a currently approved collection	2012-08-20	Withdrawn and continue
200907-0925-001	Extension without change of a currently approved collection	2009-07-02	Approved without change
200706-0925-002	No material or nonsubstantive change to a currently approved collection	2007-06-19	Improperly submitted and continue
200607-0925-004	Revision of a currently approved collection	2006-07-07	Approved without change
200309-0925-002	Revision of a currently approved collection	2003-09-26	Approved without change
200008-0925-001	Revision of a currently approved collection	2000-08-07	Approved without change
199705-0925-003	Reinstatement with change of a previously approved collection	1997-05-23	Approved without change
198906-0925-012	No material or nonsubstantive change to a currently approved collection	1989-06-30	Approved with change
198904-0925-008	No material or nonsubstantive change to a currently approved collection	1989-04-07	Approved with change
198809-0925-004	Reinstatement with change of a previously approved collection	1988-09-14	Approved without change
198611-0925-002	No material or nonsubstantive change to a currently approved collection	1986-11-20	Approved with change
198510-0925-004	Reinstatement with change of a previously approved collection	1985-10-23	Approved without change
198305-0925-004	New collection (Request for a new OMB Control Number)	1983-05-20	Approved without change

OMB Details

Demographic & Customer Satisfaction Questions (App.1A or 1 AB)

Federal Enterprise Architecture: Health - Health Care Services

Information collection instruments
Form	Name	Electronic access	Type
Form 1A	Customer Service and Demographic Questions	Fillable Fileable	Form
Form 1AB	Customer Service and Demographic Questions	Fillable Fileable	Form

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.