Participant Feedback for the Mary Frances Picciano Dietary Supplement Research Practicum (DSRP) on May 29–31, 2019 at the Lister Hill Auditorium (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⚠️ Notice: This information collection may be referencing outdated material.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 Participant Feedback for the Mary Frances Picciano Dietary Supplement Research Practicum (DSRP) on May 29–31, 2019 at the Lister Hill Auditorium (NLM) Form and Instruction
1 Evaluation Day 1 screenshot Evaluation Day 1_Screenshot 4-24-19.docx Form and Instruction
2 Evaluation Day 2 screenshot Evaluation Day 2_Screenshot 4-24-19 (1).docx Form and Instruction
3 Evaluation Day 3 screenshot Evaluation Day 3_Screenshot 4-24-19 (1).docx Form and Instruction
0925-0648_Practicum_Feedback_Survey_Clearance.doc Practicum Feedback Survey fast track IC Document

Information Collection (IC) Details

IC Title:	Participant Feedback for the Mary Frances Picciano Dietary Supplement Research Practicum (DSRP) on May 29–31, 2019 at the Lister Hill Auditorium (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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Evaluation Day 1 screenshot	Evaluation Day 1_Screenshot 4-24-19.docx	Yes	Yes	Fillable Fileable
Form and Instruction	2	Evaluation Day 2 screenshot	Evaluation Day 2_Screenshot 4-24-19 (1).docx	Yes	Yes	Fillable Fileable
Form and Instruction	3	Evaluation Day 3 screenshot	Evaluation Day 3_Screenshot 4-24-19 (1).docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 125	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	375	375
Annual IC Time Burden (Hours)	219	219
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Practicum Feedback Survey fast track	0925-0648_Practicum_Feedback_Survey_Clearance.doc	04/26/2019

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