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

OMB 0925-0208

This is an information collection request for a revision for three years. NCI’s Contact Center, The Cancer Information Service (CIS), currently collects demographic, customer service and smoking cessation information from clients contacting CIS by telephone, email and through LiveHelp (an online instant messaging service). Information is collected in order to properly plan, implement, and evaluate cancer education efforts and to provide smoking cessation services tailored to the individual client’s needs. Since its inception in 1976, the CIS has handled more than 12 million calls from the public. The potential universe of Cancer Information Service (CIS) clients almost 252 million respondents based on the U.S. Census estimate for 2017 of adults estimated to be 18 years and older.

The latest form for Collection of Customer Service, Demographic and Smoking/Tobacco Use Information from NCI's Contact Center, Cancer Information Service (CIS) Clients (NCI) expires 2021-11-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form 7 Cancer Info Call Backs Form
Form 5 VA Calls Back Form
Form 6 E-mail Intake form Form
Form 2 LiveHelp Clients Form
Form 4 Smoking Call Backs Form
Form 8 Customer Satisfaction Questions Form
Form 3 Smoking Cessation "Intake" Questions Form and Instruction
Form 2 Telephone Clients Demographic & Customer Satisfaction Questions Form and Instruction
Form 1 Customer Service and Demographic Questions Form and Instruction
CIS 30-day notice.pdf Supplementary Document
SSA CIS 2021 1.3.2022.docx Supporting Statement A
Appendix 10 ECRF with Screen Shots_2021.docx Supplementary Document
Appendix 8 CC Annual Data Report 2020 (1).docx Supplementary Document
Appendix 7 Confidentiality of Communications Policy (1).docx Supplementary Document
Appendix 6 Office of Human Subject Research Not Applicable (2).docx Supplementary Document
Appendix 5 PA Memo - NCI CIS Application PA Officer signed.pdf Supplementary Document
PIA.pdf Supplementary Document
Appendix 3 Facebook.docx Supplementary Document
Cancer Info Call Backs Form
VA Calls Back Form
E-mail Intake form Form
LiveHelp Clients Form
Smoking Call Backs Form
Customer Satisfaction Questions Form
Smoking Cessation "Intake" Questions Form and Instruction
Telephone Clients Demographic & Customer Satisfaction Questions Form and Instruction
Customer Service and Demographic Questions Form and Instruction

All Historical Document Collections

202201-0925-001 Approved without change	Revision of a currently approved collection	2022-01-11
201807-0925-001 Approved without change	Revision of a currently approved collection	2018-08-14
201512-0925-003 Approved with change	Revision of a currently approved collection	2015-12-28
201210-0925-004 Approved with change	Revision of a currently approved collection	2012-10-31
201208-0925-003 Withdrawn and continue	Revision of a currently approved collection	2012-08-20
200907-0925-001 Approved without change	Extension without change of a currently approved collection	2009-07-02
200706-0925-002 Improperly submitted and continue	No material or nonsubstantive change to a currently approved collection	2007-06-19
200607-0925-004 Approved without change	Revision of a currently approved collection	2006-07-07
200309-0925-002 Approved without change	Revision of a currently approved collection	2003-09-26
200008-0925-001 Approved without change	Revision of a currently approved collection	2000-08-07
199705-0925-003 Approved without change	Reinstatement with change of a previously approved collection	1997-05-23
198906-0925-012 Approved with change	No material or nonsubstantive change to a currently approved collection	1989-06-30
198904-0925-008 Approved with change	No material or nonsubstantive change to a currently approved collection	1989-04-07
198809-0925-004 Approved without change	Reinstatement with change of a previously approved collection	1988-09-14
198611-0925-002 Approved with change	No material or nonsubstantive change to a currently approved collection	1986-11-20
198510-0925-004 Approved without change	Reinstatement with change of a previously approved collection	1985-10-23
198305-0925-004 Approved without change	New collection (Request for a new OMB Control Number)	1983-05-20

OMB Details

Telephone Clients Customer Service

Federal Enterprise Architecture: Health - Health Care Services

Form 1

Customer Service and Demographic Questions

Fillable Fileable

Form and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.