View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Market Research to Inform Next Generation Physician's Data Query (PDQ) (NCI)
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Yes Yes Fillable Fileable
Form and Instruction 2 Yes Yes Fillable Fileable
Form and Instruction 3 Yes Yes Fillable Fileable
Form and Instruction 4 Yes Yes Fillable Fileable
Form and Instruction 5 Yes Yes Fillable Fileable
Form and Instruction 6 Yes Yes Fillable Fileable
Form and Instruction 7 Yes Yes Fillable Fileable
Form and Instruction 8 Yes Yes Fillable Fileable
Form and Instruction 9 Yes Yes Fillable Fileable
Form and Instruction 10 No   Paper Only
Form and Instruction 11 No   Paper Only
Form and Instruction 12 No   Paper Only
Form and Instruction 13 No   Paper Only
Form and Instruction 14 No   Paper Only
Form and Instruction 15 No   Fillable Fileable
Form and Instruction 16 No   Paper Only
Form and Instruction 17 No   Paper Only
Form and Instruction 18 No   Paper Only

Health Health Care Services

 

1,149 0
   
Individuals or Households
 
   50 %

  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 1,149 0 1,149 0 0 0
Annual IC Time Burden (Hours) 144 0 144 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Medical Directors Invitation 04/08/2019
Nurse and Non-Onc Clinical Invitation 04/08/2019
patient and Caregiver Invitation 04/08/2019
PCP, ONC, Rad Onc and Gastro Invitation 04/08/2019
Email Reminder Template with website screenshot 04/08/2019
Mini SSA PDQ 04/08/2019
Mini SSB PDQ 04/08/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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