Laboratory Training Evaluation

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

Documents and Forms

Document Name Document Type
Form 0917-0036 Laboratory Training Evaluation Form and Instruction
0917-0036 Lab Survey TrainingEvaluation_LabQuestions.docx Form and Instruction
0917-0036 Lab Survey TrainingEvaluation_LabQuestions.docx Form and Instruction
TrainingEvaluation_LabClearance Submission - IHS edited.docx Supporting Statement IC Document
TrainingEvaluation_LabClearance Submission - IHS edited.docx Supporting Statement IC Document

Information Collection (IC) Details

IC Title:	Laboratory Training Evaluation	Agency IC Tracking Number:

IC Status: Unchanged

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	0917-0036	Lab Survey	TrainingEvaluation_LabQuestions.docx		No		Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 35	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	35	35
Annual IC Time Burden (Hours)	6	6
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement	TrainingEvaluation_LabClearance Submission - IHS edited.docx	09/01/2021

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