Genetic and Rare Diseases Information Center Customer Satisfaction Survey

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⚠️ Notice: This information collection may be referencing outdated material.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 Genetic and Rare Diseases Information Center Customer Satisfaction Survey Form and Instruction
1 Survey Screenshots Attachment E - English Survey Screenshots.docx Form and Instruction
2 Script Attachment A - GARD English Scripts.docx Form
Fast-Track Form_GARD_120313_FINAL.doc Fast-Track Form_GARD_120313_FINAL IC Document
Attachment B - GARD Spanish Scripts.docx Attachment B - GARD Spanish Scripts IC Document
Attachment C - English Survey.docx Attachment C - English Survey IC Document
Attachment D - Spanish Survey.docx Attachment D - Spanish Survey IC Document
Attachment F - Spanish Survey Screenshots.docx Attachment F - Spanish Survey Screenshots IC Document

Information Collection (IC) Details

IC Title:	Genetic and Rare Diseases Information Center Customer Satisfaction Survey	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	Survey Screenshots	Attachment E - English Survey Screenshots.docx		No	No	Fillable Fileable
Form	2	Script	Attachment A - GARD English Scripts.docx		No	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 576	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	576	0	0	0	0	0
Annual IC Time Burden (Hours)	96	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 Form_GARD_120313_FINAL	Fast-Track Form_GARD_120313_FINAL.doc	02/24/2014
Attachment B - GARD Spanish Scripts	Attachment B - GARD Spanish Scripts.docx	02/24/2014
Attachment C - English Survey	Attachment C - English Survey.docx	02/24/2014
Attachment D - Spanish Survey	Attachment D - Spanish Survey.docx	02/24/2014
Attachment F - Spanish Survey Screenshots	Attachment F - Spanish Survey Screenshots.docx	02/24/2014

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