View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	[CSELS] DLS CLPF Meeting Evaluation Survey 2022	Agency IC Tracking Number:	0953-22FU

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	None	Clinical Laboratory Partners Forum meeting evaluation survey	02_CLPF Meeting Evaluation Survey in Qualtrics_05-31-22.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: 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)	3	0	3	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 (CLPF meeting June 8, 2022)	01_Request for Approval_2022 CLPF Meeting Survey_05-31-22.docx	05/31/2022
Invitation to participate in the CLPF meeting evaluation survey	03_Invitation to participate June 8 CLPF meeting evaluation survey_05-31-22.docx	05/31/2022

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