Feedback Survey for Dental Health Liaison Services

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

OMB: 0970-0401

IC ID: 270448

Documents and Forms
Document Name
Document Type
Other-Survey
Other-Survey
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Feedback Survey for Dental Health Liaison Services OHS
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Survey DHL Feedback Survey.docx Yes Yes Fillable Fileable

Community and Social Services Social Services

 

200 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Requested 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 200 0 0 0 0 200
Annual IC Time Burden (Hours) 23 0 0 0 0 23
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
FastTrack GenIC - Feedback Survey for Dental Health Liaison Services Fast Track Generic Submission Form_DHL Feedback Survey_8-27-24.docx 08/27/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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