ONC Interoperability Overall Forum Evaluation

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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0955-0003 can be found here:

Documents and Forms

Document Name Document Type
Form 0955-003 ONC Interoperability Overall Forum Evaluation Form and Instruction
0955-003 ONC Interoperability Forum Overall Evaluation 0955-0003 Final overall survey_web (003).docx Form and Instruction
0955-0003 Generic_Clearance_Submission_Forum_OMB Online_Web (1) (003).doc ONC Interoperability Overall Forum Evaluation Memo IC Document
0955-0003 Final overall survey_web (003).docx ONC Interoperability Forum Overall Evaluation IC Document

Information Collection (IC) Details

IC Title:	ONC Interoperability Overall Forum Evaluation	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	0955-003	ONC Interoperability Forum Overall Evaluation	0955-0003 Final overall survey_web (003).docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,160	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,160	2,160
Annual IC Time Burden (Hours)	3	3
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
ONC Interoperability Overall Forum Evaluation Memo	0955-0003 Generic_Clearance_Submission_Forum_OMB Online_Web (1) (003).doc	08/12/2019
ONC Interoperability Forum Overall Evaluation	0955-0003 Final overall survey_web (003).docx	08/14/2019

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