View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	OHR Proof of Concept Assessment Surveys (OD)	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	1	Employees-Managers Pulse Check	OHR Proof of Concept Assessment_Employees-Managers Pulse Check- Screen shots (002).docx		Yes	Yes	Fillable Fileable
Form	2	Customer Survey	OHR Proof of Concept- Customer Survey- Screen shots.docx		Yes	Yes	Fillable Fileable
Form	3	Open Feedback	OHR Proof of Concept Assessment_Employees-Managers Open Feedback- Screen shots.docx		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: 566	Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 0 %

	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	6,324	0	6,324	0	0	0
Annual IC Time Burden (Hours)	527	0	527	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
fast track for OHR Proof of Concept	Fast Track Template- NIH OHR.docx	05/06/2022

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