Precision Medicine Survey Pilot Study

The National Physician Survey of Precision Medicine in Cancer Treatment (NCI)

Documents and Forms

Document Name Document Type
Form 2 Precision Medicine Survey Pilot Study Form and Instruction
2 Attachment J NCI Precision Medicine Screenshots Attachment J-NCI Precision Medicine Screenshots.pdf Form and Instruction
Attach A Precision Medicine Survey.pdf Attachment A Precision Medicine Survey IC Document

Information Collection (IC) Details

IC Title:	Precision Medicine Survey Pilot Study	Agency IC Tracking Number:

Is this a Common Form? No		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	2	Attachment J NCI Precision Medicine Screenshots	Attachment J-NCI Precision Medicine Screenshots.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 175	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	175	175
Annual IC Time Burden (Hours)	58	58
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment A Precision Medicine Survey	Attach A Precision Medicine Survey.pdf	02/19/2016

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