WHR Consumer Focus Group Survey

Request for Generic Clearance to Conduct Voluntary Customer/Partner Surveys(NLM)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0476 can be found here:

Documents and Forms

Document Name Document Type
Form 1 WHR Consumer Focus Group Survey Form and Instruction
1 WHR Consumer Focus Group Survey NLM-WHR-Consumer_Focus_Group-Survey Instrument.docx Form and Instruction
NLM Generic Clearance Request Form_WHR Consumer Focus Group.doc NLM Generic Clearance Request Form_WHR Consumer Focus Group IC Document
NLM WHR Consumer Focus Group Mini-Supporting Statement .docx NLM WHR Consumer Focus Group Mini-Supporting Statement IC Document

Information Collection (IC) Details

IC Title:	WHR Consumer Focus Group Survey	Agency IC Tracking Number:

IC Status: Unchanged

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	WHR Consumer Focus Group Survey	NLM-WHR-Consumer_Focus_Group-Survey Instrument.docx		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 24	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	24	24
Annual IC Time Burden (Hours)	36	36
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
NLM Generic Clearance Request Form_WHR Consumer Focus Group	NLM Generic Clearance Request Form_WHR Consumer Focus Group.doc	10/05/2012
NLM WHR Consumer Focus Group Mini-Supporting Statement	NLM WHR Consumer Focus Group Mini-Supporting Statement .docx	10/05/2012

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