WHR Professionals 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⚠️ Notice: This information collection may be referencing outdated material.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 Professionals Focus Group Survey Form and Instruction
1 Focus Group NLM-WHR-Professionals_Focus_Group-Survey Instrument.docx Form and Instruction
NLM-WHR-Professionals_Focus_Group-Protocol-Rev_11-20-2012.docx NLM-WHR-Professionals_Focus_Group-Protocol-Rev_11-20-2012 IC Document
NLM Generic Clearance Request Form_WHR Professional Focus Group.doc NLM Generic Clearance Request Form_WHR Professional Focus Group IC Document
NLM WHR Professional Focus Group Mini-Supporting Statement_rev 11-20-2012.docx NLM WHR Professional Focus Group Mini-Supporting Statement_rev 11-20-2012 IC Document

Information Collection (IC) Details

IC Title:	WHR Professionals 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	Focus Group	NLM-WHR-Professionals_Focus_Group-Survey Instrument.docx		No	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	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	50	50
Annual IC Time Burden (Hours)	75	75
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
NLM-WHR-Professionals_Focus_Group-Protocol-Rev_11-20-2012	NLM-WHR-Professionals_Focus_Group-Protocol-Rev_11-20-2012.docx	11/29/2012
NLM Generic Clearance Request Form_WHR Professional Focus Group	NLM Generic Clearance Request Form_WHR Professional Focus Group.doc	11/28/2012
NLM WHR Professional Focus Group Mini-Supporting Statement_rev 11-20-2012	NLM WHR Professional Focus Group Mini-Supporting Statement_rev 11-20-2012.docx	11/28/2012

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