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Agenda
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ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Bundled Sub-studies #5 DCP Survey, #6 R2R Survey, and #7 PS-OC Survey
Agency IC Tracking Number:
IC Status:
New
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
DCP Survey Screenshots
#5_Attach 2_DCP_Survey_Screenshots.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
2
R2R Survey
#6_Attach 1_R2R Survey _Screenshots_1-30-12.docx
Yes
Yes
Fillable Fileable
Form and Instruction
3A
#7_Attach 2A_Administrators
#7_OSPO_Attach 2A_Administrators (Section A).pdf
Yes
Yes
Fillable Fileable
Form and Instruction
3B
#7_Attach2B_Education
#7_OSPO_Attach 2B_Education and Training Unit Leaders (Sections A and E).pdf
Yes
Yes
Fillable Fileable
Form and Instruction
3C
#7_Attach2C_Principal
#7_OSPO_Attach 2C_Principal and Scientific Investigators (Sections B & J).pdf
Yes
Yes
Fillable Fileable
Form and Instruction
3D
#7_Attach2D_Project Investigators
#7_OSPO_Attach 2D_Project Investigators (Sections C & J).pdf
Yes
Yes
Fillable Printable
Form and Instruction
3E
#7_Attach2E_Outreach
#7_OSPO_Attach 2E_Outreach and Education Unit Leaders (Section D).pdf
Yes
Yes
Fillable Fileable
Form and Instruction
3F
#7_Attach2F_Advocates
#7_OSPO_Attach 2F_Advocates (Section F).pdf
Yes
Yes
Fillable Fileable
Form and Instruction
3H
#7_Attach2H_Trainees
#7_OSPO_Attach 2H_Trainees (Sections H &J).pdf
Yes
Yes
Fillable Fileable
Form and Instruction
3G
#7_Attach2G_Advisors
#7_OSPO_Attach 2G_External Advisors & Scientists Not Associated (Section G).pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
SORN #09-25-0156, "Records of Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public Health Service, HHS/PHS/NIH/OD"
FR Citation:
67 FR 60743
Number of Respondents:
2,217
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
2,217
0
0
0
0
0
Annual IC Time Burden (Hours)
351
0
0
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
#5 Fast Track Request DCP
Fast-Track Request_#5_DCP.docx
02/16/2012
#5_Attach 1_DCP_invite
#5_Attach 1_DCP_invite.docx
02/16/2012
#7_OSPO_Attach 1_ Invite Letter
#7_OSPO_Attach 1_ Invite Letter.docx
02/16/2012
Summary Memo
Memo to OMB_Key To Bundled #5, #6, and #7.doc
02/24/2012
Fast-Track Request #7_OSPO
Fast-Track Request_#7_OPSO_2-24-2012.docx
02/24/2012
Fast-Track Request #6_R2R
Fast-Track Request_#6_R2R_2-24-12.docx
02/24/2012
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.