Website portal for Submission of Supplemental Evidence and Data for Systematic Reviews

Online Submission Form for Supplemental Evidence and Data for Systematic Reviews for the Evidence-based Practice Center Program

Documents and Forms

Document Name Document Type
Form 1 Website portal for Submission of Supplemental Evidence and Data for Systematic Reviews Form and Instruction
1 Attachment B Online Submission Form Attachment B_Onine Submission Form_Effective Health Care website 6.29.22.docx Form and Instruction
1 Attachment B Online Submission Form Attachment B_Onine Submission Form_Effective Health Care website 6.29.22.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Website portal for Submission of Supplemental Evidence and Data for Systematic Reviews	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	1	Attachment B Online Submission Form	Attachment B_Onine Submission Form_Effective Health Care website 6.29.22.docx		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: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	200	195	5
Annual IC Time Burden (Hours)	50	49	1
Annual IC Cost Burden (Dollars)	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.