User Satisfaction Surevy for MICAD Users

Request for Generic Clearance to Conduct Voluntary Customer/Partner Surveys(NLM)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0476 can be found here:

Documents and Forms

Document Name Document Type
Form 1 User Satisfaction Surevy for MICAD Users Form and Instruction
1 Survey for MICAD Users screenshots MICAD_survey_sceenshots_7_18_2012[1].pdf Form and Instruction
MICAD 2012 - NLM Mini-Supporting Statement_ML Surveys_MICAD Users August 2012 FINAL.doc Mini Supporting Statement IC Document
MICAD 2012 - NLM Generic Clearance Request Form_MICAD Survey July 2012.doc Generic Clearance Request Form IC Document

Information Collection (IC) Details

IC Title:	User Satisfaction Surevy for MICAD Users	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
Form and Instruction	1	Survey for MICAD Users screenshots	MICAD_survey_sceenshots_7_18_2012[1].pdf		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 300	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	10	10
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Mini Supporting Statement	MICAD 2012 - NLM Mini-Supporting Statement_ML Surveys_MICAD Users August 2012 FINAL.doc	08/15/2012
Generic Clearance Request Form	MICAD 2012 - NLM Generic Clearance Request Form_MICAD Survey July 2012.doc	08/15/2012

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