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Federal forms, ICRs, and supporting documents

Information Collection

Radiology Patient Satisfaction Survey

IC 278141 under ICR 202505-0704-008 · OMB 0704-0553.

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

View Information Collection (IC)

Radiology Patient Satisfaction Survey
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Web survey Radiology Patient Satisfaction Survey - screenshots_11.14.2025.docx Yes Yes Fillable Fileable

Defense and National Security Operational Defense

 

12,500 0
   
Individuals or Households
 
   100 %

  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 12,500 0 12,500 0 0 0
Annual IC Time Burden (Hours) 417 0 417 0 0 0
Annual IC Cost Burden (Dollars) 13,619 0 13,619 0 0 0

Title Document Date Uploaded
One Pager Justification One Pager Justification_Radiology Satisfaction Survey_11.20.2025.docx 12/02/2025
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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