Form 001_OCIC

Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration

HRSA IC Live Help Feedback Survey

HRSA Information Center Live Help Online

OMB: 0915-0212

Document [doc]
Download: doc | pdf

HRSA IC Live Help Feedback Survey


  1. Are you satisfied with the assistance you received from the HRSA Information Center (IC) Live Help?

  • Yes

  • No

  1. Please share any comments about your experience. (text box)

  2. Are there any resources that we can provide to make future conversations more effective? (text box)

  3. Did you experience any technical problems with your connection to Live Help?

  • Yes

  • No


  1. If so, please explain. (text box)



If you would like us to contact you to follow-up about a pending issue, please click here and you will be directed to the HRSA IC “Contact Us” page.  Your request is not linked to your submission form and your responses are anonymous and confidential.


File Typeapplication/msword
File TitleLive Help Feedback Form
Authorllaughnan
Last Modified Byjwalters
File Modified2010-02-04
File Created2009-10-15

© 2024 OMB.report | Privacy Policy