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PHS Human Subjects and Clinical Trial Information (Part of Final RPPR, includes inclusion/enrollment)
PHS Research Performance Progress Report and Other Post-award Reporting (OD)
OMB: 0925-0002
IC ID: 225115
OMB.report
HHS/NIH
OMB 0925-0002
ICR 202012-0925-002
IC 225115
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0002 can be found here:
2024-09-25 - Revision of a currently approved collection
2022-10-06 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 23
PHS Human Subjects and Clinical Trial Information (Part of Final RPPR, includes inclusion/enrollment)
Form and Instruction
23 PHS Human Subjects and Clinical Trial Information- Inclu
Attachment 5B PHS Human Subjects and Clinical Trial Information - Inclusion Enrollment Report_FORMS-F.pdf
Form and Instruction
24 PHS Human Subjects and Clinical Trial Information Sectio
Attachment 5B PHS Human Subjects and Clinical Trial Information - Sections 1-6_Includes Inclusion Enrollment Report_FORMS-F.pdf
Form and Instruction
22 PHS Human Subjects and Clinical Trial Information Landin
Attachment 5B PHS Human Subjects and Clinical Trial Information - Landing Page_FORMS-F.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
PHS Human Subjects and Clinical Trial Information (Part of Final RPPR, includes inclusion/enrollment)
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
23
PHS Human Subjects and Clinical Trial Information- Inclusion Enrollment Report
Attachment 5B PHS Human Subjects and Clinical Trial Information - Inclusion Enrollment Report_FORMS-F.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
24
PHS Human Subjects and Clinical Trial Information Sections 1-6
Attachment 5B PHS Human Subjects and Clinical Trial Information - Sections 1-6_Includes Inclusion Enrollment Report_FORMS-F.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
22
PHS Human Subjects and Clinical Trial Information Landing Page
Attachment 5B PHS Human Subjects and Clinical Trial Information - Landing Page_FORMS-F.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
3,600
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
3,600
0
0
0
0
3,600
Annual IC Time Burden (Hours)
14,400
0
0
0
0
14,400
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.