Clinical Electives Program 1 Year Alumni Survey

Impact of Clinical Research Training and Medical Education at the Clinical Center on Physician Careers in Academia and Clinical Research (CC)

Documents and Forms

Document Name Document Type
Form 1 Clinical Electives Program 1 Year Alumni Survey Form
1 Survey Attachment 1_ Clinical Electives Program.pdf Form
1 Survey Attachment 1_ Clinical Electives Program.pdf Form

Information Collection (IC) Details

IC Title:	Clinical Electives Program 1 Year Alumni Survey	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	1	Survey	Attachment 1_ Clinical Electives Program.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: 09-25-0014 Clinical Research: Student Records, HHS/NIH/OD/OIR/OE	FR Citation: 67 FR 60741

Number of Respondents: 100	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
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	33	33
Annual IC Cost Burden (Dollars)	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.