View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Clinical Practice Guideline Outreach and Communication Materials Feedback	Agency IC Tracking Number:	0920-1050-23HA

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	0920-1050	Clinical Practice Guideline Outreach and Communication Materials Feedback	Att.2_Clinical_Practice_Guideline_Materials_Feedback_Survey.docx		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:	FR Citation:

Number of Respondents: 16	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	16	0	16	0	0	0
Annual IC Time Burden (Hours)	4	0	4	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0920-1050)	Request_OMB1050_GenIC_Clinical_Practice_Guideline_Materials_Feedback_FINAL.docx	07/28/2023
Clinical Practice Guideline Outreach and Communication Materials Feedback Survey Monkey screenshot	Att.3_ScreenS_Clinical_Practice_Guideline_Materials_Feedback_SurveyMonkey.docx	07/28/2023

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