Forms and Documents

Document Name	Status
Form 1 2021 NLM NCBI PubMed Clinical Queries Survey Form	New
Form 1 2021 NLM NCBI Read Assembly Annotation Pipeline Tool (RAPT) Survey Form	New
Form 1 2021 Primo VE Service Feedback Survey (NLM) Form	New
Form 1 2021 NCBI Educational Events Feedback Survey (NLM) Form	New
Form 1 Federal COVID Response (FCR) Website User Satisfaction (OD) Form	New
Form 1 COVID19 Vaccine Perception Surveys (CC) Form	New
Form 1 ICARE Dialogues Customer feedback pre- and post-session surveys (OD/OLAW) Form	New
Form 1 Patient Perception Surveys – Behavioral Health (CC) Form and Instruction	New
Form 1 Patient Perception Survey- Non-Behavioral (CC) Form	New
Form 1 Patient Perception Survey- Non-Behavioral (CC) Form	New
Form 1 Health Information Technology Patient Satisfaction Survey (CC) Form	New
Form 1 Office of Intramural Training & Education (OITE) – Summer Internship Program (SIP) - Feedback (OD) Form	New
Form 1 Office of Intramural Training & Education (OITE) – Postbaccalaureate Training Program (PBT) - Feedback (OD) Form	New
Form 1 NIH Office of Intramural Training & Education (OITE) – Community College Day Feedback (OD) Form	New
Form 1 NIH Office of Intramural Training & Education (OITE) – Career Symposium Feedback (OD) Form	New
Form 1 Office of Intramural Training & Education (OITE) – The Mental Health and Well-Being of Biomedical Researchers – Feedback (OD) Form	New
Form 1 NIH Office of Intramural Training & Education (OITE) – Management Boot Camp Feedback (OD) Form	New
Form 1 NIH Office of Intramural Training & Education (OITE) – Graduate & Professional School Fair – Student Feedback (OD) Form	New
Form 1 NIH Office of Intramural Training & Education (OITE) – General Event Feedback (OD) Form	New
Form 1 Office of Intramural Training & Education (OITE) – Becoming a Resilient Scientist Series – Feedback (OD) Form	New
Form 1 Office of Intramural Training & Education (OITE) – Becoming a Resilient Scientist Series Summer 2020 - Feedback (OD) Form	New
Form 1 Office of Intramural Training & Education (OITE) – Academic Internship Program (AIP) - Feedback (OD) Form	New
Form 1 Partnerships for Environmental Public Health (PEPH) Aware-Act-Use – State and Local (NIEHS) Form	New
Form 1 Partnerships for Environmental Public Health (PEPH) Aware-Act-Use – Private Sector (NIEHS) Form	New
Form 1 Partnerships for Environmental Public Health (PEPH) Aware-Act-Use – Individuals/households (NIEHS) Form	New
Form 1 Partnerships for Environmental Public Health (PEPH) Aware-Act-Use - Federal (NIEHS) Form	New
Form 1 Questionnaire for assessing the needs to innovate, build, modify and fix laboratory tools & equipment (NIEHS) Form and Instruction	New
Form 1 2020 NLM My MedlinePlus Newsletter Survey (NLM) Form	New
Form 1 NLM Annual Unified Medical Language System (UMLS) Customer Feedback Survey (NLM) Form	New
Form 1 2020 NLM Site-wide Survey for Website Satisfaction (NLM) Form	New
Form 1 2020 NCBI ClinicalTrials.gov Website Usability Survey (NLM) Form and Instruction	New
Form 1 2021 Survey to Assess Meeting Format and Review Quality Among NIH Grant Reviewers (CSR) Form	New
Form 1 2021 Survey to Assess the Quality of Grant Review Among NIH Center for Scientific Review (CSR) Reviewers (CSR) Form	New
Form 1 BRAIN Explorer Feedback Survey (NINDS) Form	New
Form 1 The NINDS Public site widget Form	New
Form 1 Live Chat User Satisfaction Survey (NIDDK) Form	New
Form 1 Online survey for gathering information on the audience of the NIDDK Diabetes Discoveries & Practice Blog (NIDDK) Form	New
Form 1 NIMH Clinical Research Education, Support, and Training (CREST) Program Customer Satisfaction Survey (NIMH) Form	New
Form 1 NIMH Intramural Research Program Office of Fellowship Training (OFT) Annual Trainee Survey (NIMH) Form	New
Form 1 National Institute of Mental Health (NIMH) Professional Coalition for Research Progress Meeting Assessment Form (NIMH) Form	New
Form 1 National Institute of Mental Health (NIMH) Core Facility User Survey (NIMH) Form	New
Form 1 NIMH Information Resource Center (IRC) Customer Satisfaction Surveys for Email Information Services and Online Publications Ordering Services (NIMH) Form and Instruction	New
Form 1 NIMH IRP Laboratory/Branch Chief Performance Satisfaction Survey Form	New
30 day pub FRN2021-10665.pdf Supplementary Document	2021-05-20
Fast Track Template 2021.docx Supplementary Document	2021-04-01
2021 SSB_0925-0648_NIH Wide Fast Track Extension.docx Supporting Statement B	2021-04-01
2021 ext SSA Generic NIHWide Fast Track.docx Supporting Statement A	2021-04-01

IC Document Collections

IC ID	Document Title	Status
247272	2021 NLM NCBI PubMed Clinical Queries Survey Form	New
247271	2021 NLM NCBI Read Assembly Annotation Pipeline Tool (RAPT) Survey Form	New
247270	2021 Primo VE Service Feedback Survey (NLM) Form	New
247269	2021 NCBI Educational Events Feedback Survey (NLM) Form	New
247232	Federal COVID Response (FCR) Website User Satisfaction (OD) Form	New
247230	COVID19 Vaccine Perception Surveys (CC) Form	New
246921	ICARE Dialogues Customer feedback pre- and post-session surveys (OD/OLAW) Form	New
246553	Patient Perception Surveys – Behavioral Health (CC) Form and Instruction	New
246552	Patient Perception Survey- Non-Behavioral (CC) Form	New
246551	Patient Perception Survey- Non-Behavioral (CC) Form	New
246550	Health Information Technology Patient Satisfaction Survey (CC) Form	New
246549	Office of Intramural Training & Education (OITE) – Summer Internship Program (SIP) - Feedback (OD) Form	New
246548	Office of Intramural Training & Education (OITE) – Postbaccalaureate Training Program (PBT) - Feedback (OD) Form	New
246547	NIH Office of Intramural Training & Education (OITE) – Community College Day Feedback (OD) Form	New
246546	NIH Office of Intramural Training & Education (OITE) – Career Symposium Feedback (OD) Form	New
246545	Office of Intramural Training & Education (OITE) – The Mental Health and Well-Being of Biomedical Researchers – Feedback (OD) Form	New
246544	NIH Office of Intramural Training & Education (OITE) – Management Boot Camp Feedback (OD) Form	New
246543	NIH Office of Intramural Training & Education (OITE) – Graduate & Professional School Fair – Student Feedback (OD) Form	New
246542	NIH Office of Intramural Training & Education (OITE) – General Event Feedback (OD) Form	New
246538	Office of Intramural Training & Education (OITE) – Becoming a Resilient Scientist Series – Feedback (OD) Form	New
246527	Office of Intramural Training & Education (OITE) – Becoming a Resilient Scientist Series Summer 2020 - Feedback (OD) Form	New
246526	Office of Intramural Training & Education (OITE) – Academic Internship Program (AIP) - Feedback (OD) Form	New
246518	Partnerships for Environmental Public Health (PEPH) Aware-Act-Use – State and Local (NIEHS) Form	New
246517	Partnerships for Environmental Public Health (PEPH) Aware-Act-Use – Private Sector (NIEHS) Form	New
246516	Partnerships for Environmental Public Health (PEPH) Aware-Act-Use – Individuals/households (NIEHS) Form	New
246514	Partnerships for Environmental Public Health (PEPH) Aware-Act-Use - Federal (NIEHS) Form	New
246438	Questionnaire for assessing the needs to innovate, build, modify and fix laboratory tools & equipment (NIEHS) Form and Instruction	New
246437	2020 NLM My MedlinePlus Newsletter Survey (NLM) Form	New
246436	NLM Annual Unified Medical Language System (UMLS) Customer Feedback Survey (NLM) Form	New
246435	2020 NLM Site-wide Survey for Website Satisfaction (NLM) Form	New
246434	2020 NCBI ClinicalTrials.gov Website Usability Survey (NLM) Form and Instruction	New
246433	2021 Survey to Assess Meeting Format and Review Quality Among NIH Grant Reviewers (CSR) Form	New
246432	2021 Survey to Assess the Quality of Grant Review Among NIH Center for Scientific Review (CSR) Reviewers (CSR) Form	New
246430	BRAIN Explorer Feedback Survey (NINDS) Form	New
246429	The NINDS Public site widget Form	New
246427	Live Chat User Satisfaction Survey (NIDDK) Form	New
246425	Online survey for gathering information on the audience of the NIDDK Diabetes Discoveries & Practice Blog (NIDDK) Form	New
246424	NIMH Clinical Research Education, Support, and Training (CREST) Program Customer Satisfaction Survey (NIMH) Form	New
246423	NIMH Intramural Research Program Office of Fellowship Training (OFT) Annual Trainee Survey (NIMH) Form	New
246418	National Institute of Mental Health (NIMH) Professional Coalition for Research Progress Meeting Assessment Form (NIMH) Form	New
246409	National Institute of Mental Health (NIMH) Core Facility User Survey (NIMH) Form	New
246407	NIMH Information Resource Center (IRC) Customer Satisfaction Surveys for Email Information Services and Online Publications Ordering Services (NIMH) Form and Instruction	New
246406	NIMH IRP Laboratory/Branch Chief Performance Satisfaction Survey Form	New

ICR Details

OMB Control No:	ICR Reference No:
Status:	Previous ICR Reference No:
Agency/Subagency:	Agency Tracking No:
Title:
Type of Information Collection:	Common Form ICR:
Type of Review Request:	Date Received in OIRA:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract:

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR?

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Number of Information Collection (IC) in this ICR: 0

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ICR Summary of Burden

	Total	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	0	0	0	0	0	0
Annual Time Burden (Hours)	0	0	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion:

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion:

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government:

Does this IC contain surveys, censuses, or employ statistical methods?

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.    

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.    

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?

Is this ICR related to the Pandemic Response?

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Common Form ICR: 

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date:

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