NIMH Website Survey

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

⚠️ Notice: This information collection may be referencing outdated material.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 NIMH Website Survey Form and Instruction
1 NIMH Website Survey NIMH Website Survey Screenshots.pdf Form and Instruction
NIH-Fast-Track-Template.NIMH-Website-Survey-FINALv2-1.pdf Fast-track template IC Document

Information Collection (IC) Details

IC Title:	NIMH Website 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	NIMH Website Survey	NIMH Website Survey Screenshots.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10,000	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	10,000	10,000
Annual IC Time Burden (Hours)	2,500	2,500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Fast-track template	NIH-Fast-Track-Template.NIMH-Website-Survey-FINALv2-1.pdf	10/06/2015

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