View Information Collection (IC)

View Information Collection (IC)

IC Title:	Healthcare.gov Visitor Satisfaction 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			0990-0379_hcgov-vocquestions-v4.pdf		Yes	Yes	Fillable Fileable
Other-survey			0990-0379_VOC Questions - HealthCaregov - Page Level.docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 6,000	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	6,000	0	0	0	0	0
Annual IC Time Burden (Hours)	167	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
0990-0379_Generic Clearance Submission Template - HealthCaregov (3)	0990-0379_Generic Clearance Submission Template - HealthCaregov (3).docx	01/27/2012

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