Health Science Data Needs Assessment (NLM)

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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Health Science Data Needs Assessment (NLM) Form
1 Health Science Data Needs As survey instrument NLM SurveyMonkey Instrument_Health Science Data Needs As 11_5_18.pdf Form
NLM Fast Track ICR_NLM Health Science Data Needs Assessment.doc NLM fast track ICR_Health Science Data Needs Assessment IC Document

Information Collection (IC) Details

IC Title:	Health Science Data Needs Assessment (NLM)	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	1	Health Science Data Needs As survey instrument	NLM SurveyMonkey Instrument_Health Science Data Needs As 11_5_18.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
NLM fast track ICR_Health Science Data Needs Assessment	NLM Fast Track ICR_NLM Health Science Data Needs Assessment.doc	11/05/2018

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