MedWatch Safety Alert Email Service Customer Satisfaction Survey

Customer/Partner Service Surveys - (Extension)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0360 can be found here:

Documents and Forms

Document Name Document Type
MedWatchSurvey5 4 10wSkipLogic.pdf Other-customer satisfaction survey
CustomerSatisfactionEmail.doc CustomerSatisfactionEmail IC Document
OMB_clearance_memo_Finaldraft5 5 10-Wojas.doc OMB_clearance_memo_Finaldraft5 5 10-Wojas IC Document

Information Collection (IC) Details

IC Title:	MedWatch Safety Alert Email Service Customer Satisfaction Survey	Agency IC Tracking Number:

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
Other-customer satisfaction survey			MedWatchSurvey5 4 10wSkipLogic.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	5,000	0	0	0	0	0
Annual IC Time Burden (Hours)	415	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
CustomerSatisfactionEmail	CustomerSatisfactionEmail.doc	05/05/2010
OMB_clearance_memo_Finaldraft5 5 10-Wojas	OMB_clearance_memo_Finaldraft5 5 10-Wojas.doc	05/05/2010

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