CIS LiveHelp Questionnaire (Appendix 1B_REV)

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

OMB: 0925-0208

IC ID: 189803

Documents and Forms
Information Collection (IC) Details

View Information Collection (IC)

CIS LiveHelp Questionnaire (Appendix 1B_REV)
 
No Removed
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 3 LiveHelp Questionnaire Appendix 1B_REV_LiveHelp Questions.doc Yes Yes Fillable Fileable

Health Illness Prevention

"Records of Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public Health Service, HHS/PHS/NIH/OD"  77 FR 60743

7,800 0
   
Individuals or Households
 
   100 %

  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 0 0 0 -7,800 0 7,800
Annual IC Time Burden (Hours) 0 0 0 -260 0 260
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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