OMB
.report
Search
eConsent surveys
Comprehensive Communication Campaign for HITECH ACT
OMB: 0990-0376
IC ID: 200902
OMB.report
HHS/HHSDM
OMB 0990-0376
ICR 201106-0990-003
IC 200902
( )
Documents and Forms
Document Name
Document Type
0990-0376_20111215_eConsent_Survey_v1.docx
Other-survey
0990-0376_eConsent surveyMini Supporting Statement Approved Generic.docx
0990-0376_eConsent surveyMini Supporting Statement Approved Generic
IC Document
0990-0376_20111215_eConsent_cover_letter_v1.docx
0990-0376_20111215_eConsent_cover_letter_v1
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
eConsent surveys
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-survey
0990-0376_20111215_eConsent_Survey_v1.docx
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
2,800
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
2,800
0
0
0
0
0
Annual IC Time Burden (Hours)
233
0
0
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
0990-0376_eConsent surveyMini Supporting Statement Approved Generic
0990-0376_eConsent surveyMini Supporting Statement Approved Generic.docx
12/21/2011
0990-0376_20111215_eConsent_cover_letter_v1
0990-0376_20111215_eConsent_cover_letter_v1.docx
12/21/2011
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.