Opportunities for Extramural Collaborations at the NIH Clinical Center (U01) Customer Satisfaction Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NICHD)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0643 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Opportunities for Extramural Collaborations at the NIH Clinical Center (U01) Customer Satisfaction Survey Form and Instruction
1 Online customer satisfaction survey screen shots 0925-0643_CC Customer Satisfaction Survey Screenshots_8-13-14.docx Form and Instruction
0925-0643_CC Customer Satisfaction Survey_Generic Template (2).doc Fast-Track Template IC Document

Information Collection (IC) Details

IC Title:	Opportunities for Extramural Collaborations at the NIH Clinical Center (U01) Customer Satisfaction Survey	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 and Instruction	1	Online customer satisfaction survey screen shots	0925-0643_CC Customer Satisfaction Survey Screenshots_8-13-14.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Fast-Track Template	0925-0643_CC Customer Satisfaction Survey_Generic Template (2).doc	08/28/2014

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