The National Institute of Allergy and Infectious Diseases, Pan-American Health Organization, and World Health Organization, Gaps and Opportunities in Chikungunya Research: Expert Consultation on Chiku

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NIAID)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0668 can be found here:

Documents and Forms

Document Name Document Type
Form 1 The National Institute of Allergy and Infectious Diseases, Pan-American Health Organization, and World Health Organization, Gaps and Opportunities in Chikungunya Research: Expert Consultation on Chiku Form and Instruction
1 Survey Screenshots OGR Chikungunya Survey - Online Survey Screenshots_v4.docx Form and Instruction
2 Survey OGR Chikungunya Survey 7 24 2015.docx Form and Instruction
Fast Track Template 2015_NIAID_OGR Chikungunya -SPEB.doc Fast-Track Template IC Document

Information Collection (IC) Details

IC Title:	The National Institute of Allergy and Infectious Diseases, Pan-American Health Organization, and World Health Organization, Gaps and Opportunities in Chikungunya Research: Expert Consultation on Chiku	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
Form and Instruction	1	Survey Screenshots	OGR Chikungunya Survey - Online Survey Screenshots_v4.docx		Yes	Yes	Fillable Fileable
Form and Instruction	2	Survey	OGR Chikungunya Survey 7 24 2015.docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 150	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	150	150
Annual IC Time Burden (Hours)	38	38
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Fast-Track Template	Fast Track Template 2015_NIAID_OGR Chikungunya -SPEB.doc	07/27/2015

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