The World Trade Center (WTC) Health Program Call Center Satisfaction Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NIOSH 2)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0953 can be found here:

Documents and Forms

Document Name Document Type
The World Trade Center (WTC) Health Program Call Center Satisfaction Survey Form and Instruction
WTCHP Call Center Stisfaction Survey - Program Members Attachment A- WTCHP Program members.docx Form and Instruction
WTCHP Call Center Stisfaction Survey - Clinical Centers Attachment B- Clinical Centers of Excellence.docx Form and Instruction
WTCHP Call Center Stisfaction Survey - Health Providers Attachment C- Health Providers.docx Form and Instruction
WTCHP Call Center Stisfaction Survey - Pharmacists Attachment D- Pharmacists.docx Form and Instruction
App-CallCenter Request form.doc GenIC Request IC Document
WTC Health Program Call Center Customer Satisfaction Survey- Chinese.docx WTCHP Call Center Stisfaction Survey - Chinese IC Document
WTC Health Program Call Center Customer Satisfaction Survey- Polish.docx WTCHP Call Center Stisfaction Survey - Polish IC Document
WTC Health Program Call Center Customer Satisfaction Survey- Spanish.docx WTCHP Call Center Stisfaction Survey - Spanish IC Document

Information Collection (IC) Details

IC Title:	The World Trade Center (WTC) Health Program Call Center Satisfaction Survey	Agency IC Tracking Number:	16HN

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	WTCHP Call Center Stisfaction Survey - Program Members	Attachment A- WTCHP Program members.docx	NA	Yes	Yes	Fillable Fileable
Form and Instruction	NA	WTCHP Call Center Stisfaction Survey - Clinical Centers of Excellence	Attachment B- Clinical Centers of Excellence.docx	NA	Yes	Yes	Fillable Fileable
Form and Instruction	NA	WTCHP Call Center Stisfaction Survey - Health Providers	Attachment C- Health Providers.docx	NA	Yes	Yes	Fillable Fileable
Form and Instruction	NA	WTCHP Call Center Stisfaction Survey - Pharmacists	Attachment D- Pharmacists.docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 26,350	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	79,050	79,050
Annual IC Time Burden (Hours)	1,318	1,318
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
GenIC Request	App-CallCenter Request form.doc	12/23/2015
WTCHP Call Center Stisfaction Survey - Chinese	WTC Health Program Call Center Customer Satisfaction Survey- Chinese.docx	12/23/2015
WTCHP Call Center Stisfaction Survey - Polish	WTC Health Program Call Center Customer Satisfaction Survey- Polish.docx	12/23/2015
WTCHP Call Center Stisfaction Survey - Spanish	WTC Health Program Call Center Customer Satisfaction Survey- Spanish.docx	12/23/2015

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