User Survey for IHM database and website

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⚠️ Notice: This information collection may be referencing outdated material.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 User Survey for IHM database and website Form and Instruction
1 IHM Survey NLM IHM SurveyMonkey screen shot.pdf Form and Instruction
NIH fast track clearance request - NLM HMD IHM Survey.docx NIH fast track clearance request - NLM HMD IHM Survey IC Document
NLM HMD IHM survey invite.docx NLM HMD IHM survey invite IC Document

Information Collection (IC) Details

IC Title:	User Survey for IHM database and website	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	IHM Survey	NLM IHM SurveyMonkey screen shot.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

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	100	0	0	0	0	0
Annual IC Time Burden (Hours)	8	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
NIH fast track clearance request - NLM HMD IHM Survey	NIH fast track clearance request - NLM HMD IHM Survey.docx	04/12/2013
NLM HMD IHM survey invite	NLM HMD IHM survey invite.docx	04/12/2013

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