User Insights for NCHHSTP Atlas Website and Tool Review- Interviews

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NCHHSTP)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1027 can be found here:

Documents and Forms

Document Name Document Type
User Insights for NCHHSTP Atlas Website and Tool Review- Interviews Form and Instruction
Facilitator Script Interview Att1-FacilitatorScript-Interview Final.docx Form and Instruction
NCHHSTP Atlas_FastTrackSubmission ShortForm-Interviews.docx Fast Track GenIC Request IC Document

Information Collection (IC) Details

IC Title:	User Insights for NCHHSTP Atlas Website and Tool Review- Interviews	Agency IC Tracking Number:	16IP

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	NA	Facilitator Script Interview	Att1-FacilitatorScript-Interview Final.docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 30	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	30	30
Annual IC Time Burden (Hours)	15	15
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Fast Track GenIC Request	NCHHSTP Atlas_FastTrackSubmission ShortForm-Interviews.docx	12/30/2015

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