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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
"The Nuts and Bolts of Group Randomized Trials" Participant Feedback Survey
New
30
5
0
Form and Instruction
1
SurveyMonkey SBM Evaluation
2015 NIH Single Cell Analysis Investigators Meeting Survey
New
20
7
0
Form and Instruction
1
2015 NIH Single Cell Analysis Investigators Meeting Survey
2016 Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Principle Investigators' (PI) Meeting Post-Conference Evaluation Survey
New
1000
83
0
Form and Instruction
1
2016 BRAIN PI Meeting Survey Screenshots
2016 HHS Learning Portal (LMS) User Survey
New
150
13
0
Form
1
2016 HHS Learning Portal (LMS)
2017 GSRP Website Survey Applicant
New
26
4
0
Form
1
2017 GSRP Website Survey
2017 Graduate Student Recruitment Program (GSRP)
New
26
9
0
Form
1
2107 GSRP Survey
2018 NLM SIS Emerging Adults Health Needs Assessment
New
127
57
0
Form and Instruction
1
SIS Emerging Adults Focus Group survey instrument
Form
2
SIS Emerging Adults Web Based Survey instrument
Analytical Methods and Reference Materials Program Stakeholder Interviews (For Profit)
New
15
5
0
Form and Instruction
ODS Interview Guide for AMRA Stakeholders
1
Analytical Methods and Reference Materials Program Stakeholder Interviews (Not for Profit)
New
10
3
0
Form and Instruction
1
ODS Interview Guide for AMRA Stakeholders
Awardees Feedback Survey on NHLBI PAR-10-005 and PAR-13-002, NHLBI Clinical Trial Pilot Studies (R34)
New
29
29
0
Form and Instruction
1
Email Survey
Basic electronic survey to inform development of a nursing research brochure (NINR)
New
100
25
0
Form and Instruction
1
NINR Survey instrument
Form and Instruction
1
NINR Survey screenshots
Benefits & Payroll Liaison Branch (BLPB) Customer Satisfaction Survey
New
150
13
0
Form
1
Retiree Survey
Brother, You're on My Mind (BYOMM) After Action Report
New
600
50
0
Form and Instruction
1
BYOMM After Action
Brother, You're on My Mind (BYOMM) Knowledge Attitudes and Believes Form
New
600
50
0
Form and Instruction
1
BYOMM KAB Form
CSR Poll on Grant Award Productivity using the Relative Citation Ratio (RCR)
New
3000
100
0
Form
1
CSR Questions MAG
CSR Website Redesign Novice Applicants & Reviewer Interviews
New
10
10
0
Form
1
Applicant survey
Form
2
Reviewer questions
CTSU Website Customer Satisfaction Surveys
New
600
100
0
Form and Instruction
1
1 NCA Survey
Form and Instruction
1
2 General CTSU Website Survey
Career Symposium Feedback
New
1475
124
0
Form and Instruction
1
CAREER SYMPOSIUM FEEDBACK
Chair Survey
New
300
10
0
Form and Instruction
1
Chair Fair Survey
Other-E-mail
Change Readiness Survey
New
300
25
0
Form
1
Change Readiness Survey
Children's Health Exposure Assessment Resource (CHEAR) Client Satisfaction Survey
New
75
19
0
Form and Instruction
1
CHEAR Client Satisfaction Survey
Community Health Maps Project User Survey
New
100
17
0
Form and Instruction
1
Survey Screenshots
Customer Feedback on NIH's Targeted Guidance for New Investigators
New
1050
175
0
Form and Instruction
1
Survey Screenshot
Customer Satisfaction with the Contribution of Site Visits to Assess Institutional Training Grant Applications (NIGMS)
New
67
11
0
Form
1
Sit Visit Survey Questions
DIS Immigration Conference Evaluation Survey
New
50
4
0
Form
1
DIS Immigration Conference Evaluation Survey
Other-E-mail
DSSEM Application and Interview Satisfaction Survey
New
50
4
0
Form and Instruction
1
DSSEM Application and Interview Survey
DVR Animal Services Needs Assessment
New
10
1
0
Form
1
DVR Needs Assessment Survey
DVR Customer Service Survey - Animal Procurement
New
70
6
0
Form
1
Animal Procurement Survey
DVR Customer Service Survey - Animal Transportation Services
New
30
3
0
Form
1
FY17 Animal Transportation Survey
DVR Cutomer Service Survey - Animal Services
New
250
63
0
Form
1
Animal Services Survey
Data and Safety Monitoring Meeting Evaluation
New
300
50
0
Form and Instruction
1
KAI Research Questions for NIAMS Customer Survey
Form and Instruction
1 (Screenshots)
KAI Research Questions for NIAMS Customer Survey
DrugAbuse.gov Website Feedback Survey
New
12000
200
0
Form and Instruction
1
NIDA- Website Feedback Survey Screenshots
Drupal Implementation and Content Enhancement (DICE) Focus Groups
New
300
45
0
Form
1
DICE Focus Group Questions
Educational Game Focus Group
New
32
32
0
Form and Instruction
1
Screeners
Form and Instruction
2
Clinical Professional Consent Form and Script
Form and Instruction
3
Teacher Consent Form and Script
Form and Instruction
4
Parent Consent Form and Scriot
Form and Instruction
5
Child Assent Form
Forecasting Science Survey
New
385
128
0
Form
1
Outsell NIH Forecasting Science Survey
Future Research Leaders Conference Survey
New
80
13
0
Form and Instruction
1
FRLC pre-conference survey screenshot
Form and Instruction
2
FRLC Post-Conference Survey Screenshot
Future Research Leaders Conference –Communication Survey
New
60
5
0
Form and Instruction
1
FRLC Communication Survey Screenshots
HHS SBIR/STTR Showcase Conference Feedback
New
500
125
0
Form
1
HHS SBIR Showcase Event Feedback Form
HMD 2018 Exhibition Program Web Usability Study
New
30
30
0
Form
1
HMD 2018 Exhibition Web Usability Study instrument
HR Systems Support (HRSS) Customer Satisfaction Survey
New
25
2
0
Form and Instruction
1
HRSS Survey
Health Information Technology Patient Satisfaction Survey (CC)
New
3000
250
0
Form and Instruction
1
Patient Portal Online Survey Screenshot
Human Resources Classification and Recruitment Documents System (HR CARDS) Survey
New
275
23
0
Form
1
HRCARD Survey Questions
Influenza Vaccine Survey
New
1400
47
0
Form
1
2016 Flu Survey
Information Management Team (IMT) Web Intercept Survey
New
60
2
0
Form and Instruction
1
IMT Intercept survey Form
IntraHR Website Customer Satisfaction Survey
New
60
2
0
Form and Instruction
1
IntraHR Customer Satisfaction Survey
KAI Annual Client Satisfaction Survey
New
30
5
0
Form and Instruction
1
KAI Annual Client Survey Printscreens
LIS User Survey of NLM Resources
New
192
32
0
Form and Instruction
1
NLM LIS User Survey Instrument
Other-Survey Invitation
LRP Ambassador Feedback
New
1350
225
0
Form and Instruction
1
LRP Ambassador Feedback
LRP Qualitative Research
New
50
25
0
Form and Instruction
1
LRP Qualitative Research
Medical Arts Branch (MAB) Services Survey
New
100
10
0
Form and Instruction
1
Medical Arts Branch Survey
Other-Email
Medicine: Mind the Gap NIH Seminar Series Survey-For Profits
New
150
13
0
Form and Instruction
1
Customer Satisfaction Survey
Medicine: Mind the Gap NIH Seminar Series Survey-Not-For-Profits
New
150
13
0
Form and Instruction
1
Customer Satisfaction Survey
Medicine: NIH Mind the Gap Webinar Series Survey II
New
300
25
0
Form
1
MtG Customer Satisfaction Survey - survey Monkey Screnshot
NCBI 2017 Sequence Database User Survey
New
625
31
0
Form
1
NCBI Sequence Database User Survey
NCBI 2017 Website User Survey
New
10500
350
0
Form
1
NCBI 2017 Website User Survey Instrument
NCBI 2018 Genetics and Population Frequency Data Survey (NLM)
New
300
10
0
Form
1
NCBI 2018 Genetics and Population Frequency Data instrument
NCBI BLAST Web Services 2017 Survey
New
300
25
0
Form
1
NCBI BLAST Web Services 2017 Survey Instrument
NCBI Medical Genetics and Variation Web Resources 2017 Survey
New
400
7
0
Form
1
NCBI Medical Genetics 2017 Survey Instrument
NCCIH Customer Service Data Collection
New
412
30
0
Form and Instruction
1
Telephone Survey
Form and Instruction
2
Email Survey
NCI OFSM Relocation Survey - Office
New
128
4
0
Form
1
NCI OFSM Relocation Survey - Office Moves
NCI OSFM Conference Room Services Survey
New
284
9
0
Form and Instruction
1
Survey
NCI OSFM Express Services Survey
New
432
14
0
Form
1
Express Services Survey
NCI OSFM Fitness Center Survey
New
536
18
0
Form
1
NCI OSFM Fitness Survey
NCI OSFM Relocation Survey- Lab
New
128
4
0
Form
1
Lab Relocation
NCI OSFM Shuttle Service Survey
New
1500
50
0
Form and Instruction
1
NCI OSFM Shuttle Service Survey Instrument
NCI OSFM Small Little Job (SLJ) Survey
New
256
9
0
Form
1
Survey
NEI Health Focus Groups with New Audiences Ages 25-35
New
288
173
0
Form and Instruction
1
NEI Screener
Form and Instruction
2
NEI Mod Guide
NHLBI's Health Information Center (HIC)
New
20900
1372
0
Form and Instruction
1
Survey Instrument IVR
Form and Instruction
2
Survey Instrument Web Questions
NIH Events Management – Audio Visual Survey
New
60
5
0
Form and Instruction
1
FY 17 EM Audio Visual Survey
NIH Events Management – Post Production Survey
New
60
5
0
Form and Instruction
1
FY17 EM Post Production Survey
NIH Events Management – Scheduling Services Survey
New
60
5
0
Form and Instruction
1
FY17 EM Scheduling Services Survey
NIH Events Management – Video Production Survey
New
60
5
0
Form and Instruction
1
FY17 EM Video Production Survey
NIH Library Customer Satisfaction Survey
New
100
3
0
Form
1
Desk Survey May 2018
NIH Library Survey on Statistical Class Offerings
New
100
8
0
Form
1
NIH Stats Survey 2017
NIH Library Survey: Weekend Library Use
New
100
3
0
Form and Instruction
1
Weekend Use Nov 2017 Survey
NIH Native American Visit Week Feedback
New
10
1
0
Form and Instruction
1
Survey Instrument
NIH Office of Intramural Training & Education (OITE) – Community College Day Feedback
New
700
117
0
Form
1
OITE-OMBFT- Community College Day- Feedback Collection
NIH Office of Intramural Training & Education (OITE) – General Feedback Form
New
10600
530
0
Form and Instruction
1
FEEDBACK ON AN OITE EVENT
Form and Instruction
2
CAREER SERVICES CENTER
NIH Office of Intramural Training & Education (OITE) – Graduate & Professional School Fair Feedback
New
1700
142
0
Form
1
Graduate and Professional School Fair Feedback Collection
NIH Office of Intramural Training & Education (OITE) – Management Boot Camp Feedback
New
90
5
0
Form and Instruction
1
MANAGEMENT BOOT CAMP FEEDBACK Form
NIH Research Training Institutes (RTIs) Customer Satisfaction Surveys
New
3800
841
0
Form and Instruction
1
Applicants Survey
Form and Instruction
2
Faculty Survey
Form and Instruction
3
Trainee Survey
NIH Training Center Meeting Facilitation Survey
New
60
5
0
Form and Instruction
1
NIHTC Training Evaluation- Meeting Facilitation
NIMH Information Resource Center (IRC) Customer Satisfaction Surveys for Email Information Services, Online Publications Ordering Services and Telephone Services
New
2020
100
0
Form and Instruction
1
Email services survey
Form and Instruction
2
Online publications ordering services survey
Form and Instruction
3
Telephone services survey
NIMH Professional Coalition for Research Progress Meeting Assessment Form
New
65
2
0
Form
1
Professional Coalition for Research Progress Meeting Assessment form
NIMH Website Survey
New
10000
2500
0
Form and Instruction
1
NIMH Website Survey
NLM 2018 Public Libraries Association Survey
New
200
17
0
Form
1
NLM 2018 Public Libraries urvey
NLM 4 Caregivers User Survey
New
500
42
0
Form and Instruction
1
NLM 4 Caregivers 2016 User Survey Instrument
NLM AIDSource 2017 Survey
New
200
17
0
Form
1
NLM AIDSource 2017 Survey
NLM ClinVar 2016 User Survey
New
300
25
0
Form
1
NLM ClinVar 2016 User Survey Instrument
NLM ClinVar 2017 Website User Survey
New
600
50
0
Form and Instruction
1
NLM NCBI ClinVar 2017 Survey Instrument
NLM Customer Service Satisfaction Survey
New
375
31
0
Form and Instruction
1
Survey Instrument
NLM DOCLINE Customer Service Survey
New
2200
440
0
Form and Instruction
1
NLM DOCLINE Customer Service Survey Instrument
NLM GHR User Study Screening Survey
New
200
33
0
Form and Instruction
1
NLM GHR User Study Screening Survey Instrument
NLM Genetic Home Reference User Study
New
16
16
0
Form and Instruction
1
NLM GHR Use Study Interview Instrument
NLM Google Survey for MedlinePlus Page Satisfaction Rating
New
500
8
0
Form and Instruction
1
NLM MedlinePlus Google Survey Instrument
NLM Library Operations Customer Satisfaction Survey
New
700
35
0
Form and Instruction
1
NLM LO Customer Service Survey Instrument
NLM Main Website Satisfaction Survey
New
2500
42
0
Form
1
NLM Main Website Satisfaction Survey Instrument
NLM MedlinePlus Connect Customer Survey
New
50
50
0
Form and Instruction
1
Survey
NLM MedlinePlus Page Google Survey Satisfaction Rating
New
1000
17
0
Form and Instruction
1
NLM MedlinePlus Google Survey Instrument (screenshots)
NLM MedlinePlus RML User Survey
New
120
30
0
Form
1
NLM Medline Plus RML User Survey Instrument
NLM MedlinePlus Website Usability Testing
New
20
20
0
Form and Instruction
1
NLM MedlinePlus Usability Testing ICR Instrument
NLM NCBI 2018 Literature Resources Survey
New
1500
50
0
Form
1
NCBI 2018 Literature Resources Survey
NLM NCBI 2018 Representative Genomes Survey
New
250
8
0
Form
1
NCBI 2018 Representative Genomes survey instrument
NLM NCBI CCDS User Survey
New
500
42
0
Form
1
NLM NCBI CDDS Survey Instrument
NLM NCBI ClinicalTrials.gov Website Usability Survey 2017
New
803
134
0
Form
1
NLM NCBI CT Usability Survey
NLM NCBI ClinicalTrials.gov Website User Survey
New
1000
750
0
Form
1
NLM NCBI CT.gov Website User Survey Instrument
NLM NCBI GRC Website User Survey
New
500
25
0
Form and Instruction
1
NLM NCBI GRC Website User Survey Instrument
NLM NCBI Gene Resources Website Survey
New
267
200
0
Form and Instruction
1
NLM NCBI Gene Resources Website User Survey Instrument
NLM NCBI Health Resources Survey
New
500
33
0
Form and Instruction
1
NLM NCBI Health Resource Survey screenshots
NLM NCBI Microbe Conference Survey
New
120
10
0
Form and Instruction
1
NLM NCBI Microbe Conference Survey Instrument
NLM Project SHARE website assessment
New
72
72
0
Form and Instruction
1
Focus Group Questions
Other-Consent Form
NLM Reading Rooms Satisfaction Survey
New
269
22
0
Form and Instruction
1
Survey Screenshots
Form and Instruction
2
Survey (paper version)
NLM Survey for MedlinePlus Page Satisfaction
New
3000
50
0
Form
1
NLM MedlinePlus Survey Instrument
NLM TOXNET 2018 Workshop Survey
New
120
30
0
Form and Instruction
1
NLM Toxnet 2018 Workshop Survey Instrument
NLM ToxTutor User Survey
New
500
25
0
Form and Instruction
1
NLM ToxTutor User Survey Instrument
NLM Traveling Exhibition Visitor Study
New
125
31
0
Form and Instruction
1
NLM Traveling Exhibition Visitor Survey
NLM Website Survey for Website Satisfaction Rating
New
20000
667
0
Form
1
NLM Websites Survey
National Institute of Dental and Craniofacial Research (NIDCR) Website Usability Study
New
400
200
0
Form and Instruction
1
Usability Test Questions
National Institute of Dental and Craniofacial Research Focus Group Study
New
72
72
0
Form and Instruction
1
NIDCR-FG Moderator Guide
Form and Instruction
2
NIDCR Focus Group Recruitment Screener
National Institute of Mental Health (NIMH) Employee Engagement Survey
New
30
3
0
Form and Instruction
1
NIMH Employee Engangement Survey
National Institute of Mental Health (NIMH) Office of the Director and Extramural Programs Workforce Resource Analysis
New
40
50
0
Form and Instruction
1
EX Workforace Analysis Focus Group Discussion Guide
Form and Instruction
1
EX Workforace Analysis Discussion Guide
ODP Pathways to Prevention Survey -For Profits
New
150
25
0
Form and Instruction
1
Survey Screenshot
ODP Pathways to Prevention Survey -Not For Profits
New
350
58
0
Form and Instruction
1
Survey Screenshot
ODP Pathways to Prevention Survey II
New
800
133
0
Form
1
Obesity Methods P2P Survey
OER Intercept survey
New
12000
1000
0
Form
1
OER Intercept Survey questions
OHR Website Customer Satisfaction Survey
New
100
8
0
Form
1
OHR Website survey
OM All Hands Meeting Survey
New
150
13
0
Form and Instruction
1
OM All Hands Survey
ORF Workplace Aesthetic Survey (OD)
New
2500
208
0
Form and Instruction
1
NIH Rockledge Visual Vocabulary Survey
Office of Human Resources (OHR) Climate Survey
New
270
45
0
Form
1
2017 OHR Climate Survey
Office of Human Resources (OHR) Pulse Survey
New
30
3
0
Form and Instruction
1
OHR Pulse Survey
Office of Human Resources (OHR) Training Survey
New
40
4
0
Form and Instruction
1
HR Training Survey
Ombudsman Services Feedback Survey
New
15
1
0
Form and Instruction
1
NIH OOCCR Feedback Survey
Online Customer Service Survey About The Application Technical Assistance Webinar
New
200
13
0
Other-Invitation Email
Form and Instruction
1
LRP Webinar Survey
Outcomes of IDeA Core Optimization Administrative Supplements
New
34
34
0
Form
1
NIGMS CRCB IDeA Core Supplement Follow-up Questions
Participant Feedback on 2016 NIH Common Fund High-Risk, High-Reward Research Symposium
New
185
15
0
Form and Instruction
1
Survey 2016 HRHR Symposium screenshot
Participant Feedback on 2017 NIH Common Fund 2017 Stimulating Peripheral Activity to Relieve Conditions (SPARC) Research Program Annual Awardee Meeting
New
95
8
0
Form and Instruction
1
Survey screenshot
Partnerships for Environmental Public Health (PEPH) Aware-Act-Use (Federal Government)
New
238
20
0
Form
1
PEPH Aware-Act-Use
Partnerships for Environmental Public Health (PEPH) Aware-Act-Use (Private Sector)
New
266
22
0
Form
1
PEPH Aware-Act-Use Survey
Partnerships for Environmental Public Health (PEPH) Aware-Act-Use (State, Local or Tribal)
New
50
4
0
Form
1
PEP Aware-Act-Use survey
Partnerships for Environmental Public Health Program (PEPH) Aware-Act-Use Survey (Individuals/households)
New
292
24
0
Form
1
PEPH Aware-Act-Use instrument
Pathways for Teamwork Customer Satisfaction Interviews
New
24
24
0
Form
1
Needs Analysis Interview Protocol
Patient Perception Survey (CC)
New
7500
3750
0
Form and Instruction
1
NIHAIP Survey Mock-up - NRC Health
Form and Instruction
2
NIHAOP Survey Mock-up - NRC Health
Pediatric Patient Perception Survey (CC)
New
5000
2500
0
Form and Instruction
1
NRC NIH IP P Survey
Pragmatic & Group-Randomized Trials (GRT) in Public Health & Medicine Participant Feedback Survey: Parts 1-7
New
700
117
0
Form
1
MOOC Survey
PubMed Search User Survey
New
300
25
0
Form and Instruction
1
NLM PubMed Search User Survey
Qualitative Research to Explore Barriers and Facilitators for LRP Ambassadors to Promote the NIH Loan Repayment Programs
New
35
18
0
Form and Instruction
1
Key Informant Interview Guide
Shuttle Bus Survey for Fishers Lane
New
2545
424
0
Form and Instruction
1
OAS Shuttle Survey Screenshots
The Annual NIH Pain Consortium Symposium Feedback (For Profit)
New
20
1
0
Form and Instruction
1
Pain Survey
The Annual NIH Pain Consortium Symposium Feedback (Not For Profit)
New
20
1
0
Form and Instruction
1
Pain Survey
The NIH Director's Blog Readership Survey
New
1000
167
0
Form and Instruction
1
NIH Blog Survey
The NIH Director's Blog Readership Survey
New
1000
83
0
Form
1
Survey
The NIH Extramural Loan Repayment Programs: Online Customer Service Survey About the Application Technical Assistance Webinar
New
40
3
0
Form and Instruction
1
FY2018 LRP Webinar Survey
The NIH Extramural Loan Repayment Programs: Online Post-Application Customer Service Survey for Applicants – Form A
New
594
40
0
Form and Instruction
1
LRP Survey for Applicants Form A- Screenshots
Other-email
The NIH Extramural Loan Repayment Programs: Online Post-Application Customer Service Survey for Applicants – Form B
New
594
40
0
Form and Instruction
1
LRP Survey for Applicants Form B- Screenshot
Other-Email
The NIH Extramural Loan Repayment Programs: Online Post-Application Customer Service Survey for Applicants – Form C
New
594
40
0
Form and Instruction
1
LRP Survey for Applicants Form C-Screenshots
Other-email
The NIH Extramural Loan Repayment Programs: Online Post-Application Customer Service Survey for Award Applicants
New
810
68
0
Form and Instruction
1
LRP Survey for Mentors-Screenshots 2
Other-Invitation Email
The NIH Extramural Loan Repayment Programs: Online Post-Application Customer Service Survey for Institutional Business Officials (IBOs)
New
600
20
0
Form and Instruction
1
LRP IBO Survey- Screenshots
Other-Invitation Email
The NIH Extramural Loan Repayment Programs: Online Post-Application Customer Service Survey for Mentors
New
1440
48
0
Form and Instruction
1
LRP Survey for Mentors- Screenshots
Other-Invitation Email
The NIH Extramural Loan Repayment Programs: Online Post-Application Customer Service Survey for Recommenders/Referees
New
3120
104
0
Form and Instruction
1
LRP Referee Survey- Screenshots
Other-Invitation Email
Traveling Exhibition Host Survey
New
350
117
0
Form and Instruction
1
Host Survey
Other-Email
US-Japan Cooperative Medical Sciences Program (USJCMSP) 50th Anniversay and 18th International Conference on Emerging Infectious Diseases in the Pacific Rim
New
150
38
0
Form and Instruction
1
USJCP Meeting screenshots
Form and Instruction
2
USJCP Meeting feedback form
Usability testing for PHPartners.org website
New
40
30
0
Form and Instruction
1
Survey Screenshot
Variation Resources Survey
New
50
2
0
Form and Instruction
1
NLM Variation Resources User Survey
WiTS Climate Survey 2015
New
40
3
0
Form and Instruction
1
2015 WiTS Climate Survey
Workflow Information Tracking System (WiTS) Focus Groups
New
28
11
0
Form
1
WiTS Focus Group instrument
Workflow information Tracking System (WiTS) Focus Groups (OD)
New
28
42
0
Form and Instruction
1
WiTS Focus Group
Workplace and Organizational Performance Survey
New
708
177
0
Form and Instruction
1
Workplace Organizational Performance Survey
Workstyle Survey
New
300
30
0
Form and Instruction
1
Qualtrics Print
Other-Survey Email
Total Burden Actually Used for Information Collections Under Currently Approved ICR:
182667
21618
0
Total Burden Currently Requested for Information Collections Under Currently Approved ICR:
0
0
0
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