Information Collection

Client Satisfaction Survey (client)

IC 260398 under ICR 202305-0920-002 · OMB 0920-1410.

Documents and Forms

Document Name Document Type
Client Satisfaction Survey (client) Form and Instruction
TRANSCEND Satisfaction Client Survey Att3b_Survey.docx Form and Instruction
TRANSCEND Satisfaction Client Survey Att3b_Survey.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Client Satisfaction Survey (client)	Agency IC Tracking Number:

Is this a Common Form? No		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	None	TRANSCEND Satisfaction Client Survey	Att3b_Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 400	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	400	400
Annual IC Time Burden (Hours)	100	100
Annual IC Cost Burden (Dollars)	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.