View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Clinical Laboratory Partners Forum (CLPF) 2021 Survey	Agency IC Tracking Number:	0920-21HA

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	n/a	Clinical Lab Partners Forum Survey 2021	02_CLPF Survey 2021 in SurveyMonkey.pdf		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 40	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

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	40	0	40	0	0	0
Annual IC Time Burden (Hours)	7	0	7	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Template with Project Description for the CLPF Survey	01_Fast_Track_GenIC_Request_CLPF Survey_ICRO.docx	08/03/2021
Invitation to Participate in the CLPF Survey	03_Invitation to participate CLPF survey cleared_RF.docx	08/03/2021

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.