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VA Calls Back
Collection of Customer Service, Demographic and Smoking/Tobacco Use Information from NCI's Contact Center, Cancer Information Service (CIS) Clients (NCI)
OMB: 0925-0208
IC ID: 232457
OMB.report
HHS/NIH
OMB 0925-0208
ICR 202201-0925-001
IC 232457
( )
Documents and Forms
Document Name
Document Type
Form 5
VA Calls Back
Form
5 VA Calls Back
Appendix 1E VA Follow Up Calls_2021.docx
Form
5 VA Calls Back
Appendix 1E VA Follow Up Calls_2021.docx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
VA Calls Back
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
5
VA Calls Back
Appendix 1E VA Follow Up Calls_2021.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
09-25-0156, “Records of Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public Health Service
FR Citation:
67 FR 60742
Number of Respondents:
8,166
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
8,166
0
7,230
0
0
936
Annual IC Time Burden (Hours)
544
0
482
0
0
62
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.