NIH Office of the OMBudsman, Center for Cooperative Resolution, user feedback survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (OD/OER)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Document Name Document Type
Form 1 NIH Office of the Ombudsman, Center for Cooperative Resolution, user feedback survey Form and Instruction
1 Online Survey NIHOmbuds_usersurvey_screenshot_3.doc Form and Instruction
NIHOmbuds_user survey_4.docx NIHOmbuds_user survey_4 IC Document
NIHOmbuds_generic_clearance_2 (2).doc NIHOmbuds_generic_clearance_2 (2) IC Document

Information Collection (IC) Details

IC Title:	NIH Office of the Ombudsman, Center for Cooperative Resolution, user feedback 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 Survey	NIHOmbuds_usersurvey_screenshot_3.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 300	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	300	0	0	0	0	0
Annual IC Time Burden (Hours)	50	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
NIHOmbuds_user survey_4	NIHOmbuds_user survey_4.docx	11/01/2012
NIHOmbuds_generic_clearance_2 (2)	NIHOmbuds_generic_clearance_2 (2).doc	11/01/2012

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