We Care Survey, Blackfeet Community Hospital.

Fast Track Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery: IHS Customer Service Satisfaction and Similar Surveys

OMB: 0917-0036

IC ID: 216538

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

View Information Collection (IC)

We Care Survey, Blackfeet Community Hospital. 46
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0917-0036 We Care Survey, Blackfeet Community Hospital. OMB No 0917-0036 We Care Survey Survey Blackfeet Tribe.doc Yes No Fillable Printable

Health Health Care Services

 

1,200 0
   
Individuals or Households
 
   0 %

  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 1,200 0 0 0 0 1,200
Annual IC Time Burden (Hours) 100 0 0 0 0 100
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
OMB No. 0917-0036 OMB No 0917-0036 Mini-supporting statement We Care Survey Blackfeet Tribe.doc 05/11/2015
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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