OMB
.report
Search
CAREWare User Survey
Ryan White HIV/AIDS Program CAREWare Customer Satisfaction and Usage Survey
OMB: 0906-0085
IC ID: 264501
OMB.report
HHS/HRSA
OMB 0906-0085
ICR 202401-0906-004
IC 264501
( )
Documents and Forms
Document Name
Document Type
Form 1
CAREWare User Survey
Form and Instruction
1 Customer Satisfaction Survey Questionnaire
CAREWare Customer Satisfaction Survey Questionnaire Final 1.12.24.pdf
Form and Instruction
1 Customer Satisfaction Survey Questionnaire
CAREWare Customer Satisfaction Survey Questionnaire Final 1.12.24.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
CAREWare User Survey
Agency IC Tracking Number:
Is this a Common Form?
No
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
Customer Satisfaction Survey Questionnaire
CAREWare Customer Satisfaction Survey Questionnaire Final 1.12.24.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1,160
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions, Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
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
1,160
0
1,160
0
0
0
Annual IC Time Burden (Hours)
1,021
0
1,021
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.