National Center for Complementary and Alternative Medicine (NCCAM) Customer Service Data Collection

Documents and Forms

Document Name Document Type
Form 1 National Center for Complementary and Alternative Medicine (NCCAM) Customer Service Data Collection Form
1 Survey APPENDIX A Survey Instrument.doc Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	National Center for Complementary and Alternative Medicine (NCCAM) Customer Service Data Collection	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Form	1	Survey	APPENDIX A Survey Instrument.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 983	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	983	-1,066	2,049
Annual IC Time Burden (Hours)	74	-59	133
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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