NHLBI Health Information Center (HIC) Customer Satisfaction Survey Plan

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (OD/OER)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Document Name Document Type
Form 1 NHLBI Health Information Center (HIC) Customer Satisfaction Survey Plan Form and Instruction
1 Telephone Survey HIC IVR Customer Satisfaction Survey for Quality Test.docx Form and Instruction
1 Online Survey NHLBI Customer Satisfaction Survey Online Form.docx Form and Instruction
Fast-Track template NHLBI Health Information Center (HIC) Customer Satisfaction Plan.doc Fast-Track template NHLBI Health Information Center (HIC) Customer Satisfaction Plan IC Document
Invitation letter (3).docx Invitation letter (3) IC Document
Followup letter.docx Followup letter IC Document
Word Version of Screenshots.docx Word Version of Screenshots IC Document

Information Collection (IC) Details

IC Title:	NHLBI Health Information Center (HIC) Customer Satisfaction Survey Plan	Agency IC Tracking Number:

IC Status: New

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 and Instruction	1	Telephone Survey	HIC IVR Customer Satisfaction Survey for Quality Test.docx		No	No	Paper Only
Form and Instruction	1	Online Survey	NHLBI Customer Satisfaction Survey Online Form.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 950	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	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	950	0	0	0	0	0
Annual IC Time Burden (Hours)	45	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Fast-Track template NHLBI Health Information Center (HIC) Customer Satisfaction Plan	Fast-Track template NHLBI Health Information Center (HIC) Customer Satisfaction Plan.doc	11/14/2013
Invitation letter (3)	Invitation letter (3).docx	11/14/2013
Followup letter	Followup letter.docx	11/14/2013
Word Version of Screenshots	Word Version of Screenshots.docx	11/14/2013

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