Virtual Interviews with Members of the Public to Assess Customer Experience with Organ Donation PSAs

Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration

OMB: 0915-0212

IC ID: 241894

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Virtual Interviews with Members of the Public to Assess Customer Experience with Organ Donation PSAs
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Interview Guide - OMB Outreach Evaluations CLEAN.RA.docx 04.28.2020 Interview Guide - OMB Outreach Evaluations CLEAN.RA.docx Yes Yes Fillable Fileable

Health Health Care Services

 

32 0
   
Individuals or Households
 
   100 %

  Requested 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 32 0 0 0 0 32
Annual IC Time Burden (Hours) 16 0 0 0 0 16
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Recruitment Protocol - Outreach Evaluation 04.28.2020 Recruitment Protocol - OMB Outreach Evaluation CLEAN.docx 05/20/2020
Supporting Statement - Outreach Evaluation 04.28.2020 Supporting Statement - OMB Outreach Evaluation CLEAN.docx 05/20/2020
Supporting Statement - Outreach Evaluation - UPDATED 06.17.2020 Supporting Statement - Outreach Evaluation.docx 06/17/2020
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