PHE.gov Satisfaction Surveys: Exit Survey and In-Page Survey

Fast Track Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0379 can be found here:

Documents and Forms

Document Name Document Type
Survey-Exit-PHEgov-Site-Wide-Satisfaction-24Apr18.docx Other-survey
Survey-OnPage-PHEgov-Site-Wide-Satisfaction-24Apr18.docx Other-SURVEY
PHEgov Web Survey-Generic Clearance Submission-24Apr18.docx SS-A IC Document

Information Collection (IC) Details

IC Title:	PHE.gov Satisfaction Surveys: Exit Survey and In-Page Survey	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			Survey-Exit-PHEgov-Site-Wide-Satisfaction-24Apr18.docx		Yes	Yes	Fillable Fileable
Other-SURVEY			Survey-OnPage-PHEgov-Site-Wide-Satisfaction-24Apr18.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 800	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	800	800
Annual IC Time Burden (Hours)	67	67
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SS-A	PHEgov Web Survey-Generic Clearance Submission-24Apr18.docx	04/24/2018

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