Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Classroom Post Class Survey New 1000 83 0 Form and Instruction 0917-0036-05 OMB Form No. 0917-05, FY_ Classroom Post Class Survey
Employee Assessment, Clinton Service Unit, IMPRESS New 500 42 0 Form and Instruction 0917-0036-10 0917-0036-10 Employee Assessment
IHS Community Health Representative Basic Training & Refresher Training New 180 15 0 Form and Instruction 0917-0036-15 OMB Form No., 0917-0036-15, IHS community Health Representative (CHR) Basic and Refresher Training
IHS Website Customer Service Satisfaction Survey - EHR Survey New 500 83 0 Form and Instruction 0917-0036-03 Indian Health Service (IHS) Website Customer Service Satisfaction Survey - EHR Survey Monkey - CLASS
Indian Health Service Website Customer Service Satisfaction Survey New 500 125 0 Form and Instruction 0917-0036-01 IHS Website Customer Satisfaction Survey Questions
OIT Customer Satisfaction Survey - Problem Ticket New 500 42 0 Form and Instruction 0917-0036-14 OIT Customer Satisfaction Survey - Problem Ticket, OMB No. 0917-0036-14
OIT Customer Satisfaction Survey - Service Ticket New 500 42 0 Form and Instruction 0917-0036-13 OIT Customer Satisfaction Survey-Service Ticket, OMB Form No. 0917-0036-13
Patient Assessment, Clinton Service Unit, IMPRESS New 500 42 0 Form and Instruction 0917-0036-11 OMB No. 0917-0036-11, Patient Assessment
Physician/Dentist Customer Service Questionairre New 500 42 0 Form and Instruction 0917-0036-12 OMB No. 0917-0036-12, Physician & Dental Customer Service Questionnaire
Satellite Classroom Post Class Survey New 500 42 0 Form and Instruction 0917-0036-07 OMB Form No. 0917-0036-07 FY_Satellite Classroom Post Class Survey
Website Customer Service Satisfaction Survey New 500 125 0 Form and Instruction 0917-0036-002 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery: Indian Health Service (IHS) Website Customer Service Satisfaction Survey
Website Customer Service Satisfaction Survey - EHR New 500 83 0 Form 0917-0036-04 IHS Customer Satisfaction Survey; EHR Survey Monkey - VIRTUAL
eLearning Post Class Survey New 2500 208 0 Form and Instruction 0917-0036-06 OMB Form No. 0917-0036-06, FY_ e Learning Post Class Survey
iCare - CMET Post Course Survey New 75 6 0 Form and Instruction 0917-0036-08 OMB Form No. 0917-0036-08, iCare-CMET Post Course Survey
iCare Nuts and Bolts Post Class Survey New 225 19 0 Form and Instruction 0917-0036-09 OMB Form No. 0917-0036-09, iCare Nuts and Bolts Post Class Survey
Total Burden Actually Used for Information Collections Under Currently Approved ICR: 8980 999 0  
Total Burden Currently Requested for Information Collections Under Currently Approved ICR: 0 0 0  
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