National Women's Health Information Center (NWHIC) Customer Satisfaction Questionnaire

ICR 200306-0990-002

OMB: 0990-0272

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0990-0272 200306-0990-002
Historical Active
HHS/HHSDM
National Women's Health Information Center (NWHIC) Customer Satisfaction Questionnaire
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 08/06/2003
Retrieve Notice of Action (NOA) 06/16/2003
Approved for use through 8/2006 under the condition that HRSA amends the race question 29 to comply with the OMB race/ethnicity data standard.
  Inventory as of this Action Requested Previously Approved
08/31/2006 08/31/2006
1,245 0 0
144 0 0
0 0 0

The OWH requests approval to send a customer satisfaction questionnaire to users of NWHIC who have called the 1-800 number. Since its launch in 1998, NWHIC's toll-free number and services have not been evaluated to determine how well it has been fulfilling its goals. The survey is intended to assess the effectiveness of OWH in disseminating information through NWHIC. A random sample of 1,556 NWHIC users (with consent) will be mailed a survey and follow-up letter.

None
None


No

1
IC Title Form No. Form Name
National Women's Health Information Center (NWHIC) Customer Satisfaction Questionnaire

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1,245 0 0 1,245 0 0
Annual Time Burden (Hours) 144 0 0 144 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
06/16/2003


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