NLM Reading Rooms Satisfaction 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⚠️ Notice: This information collection may be referencing outdated material.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 NLM Reading Rooms Satisfaction Survey Form and Instruction
1 Survey Screenshots NLM Reading Room Survey (online version screen shots).pdf Form and Instruction
2 Survey (paper version) NLM Reading Room Survey Instrument (paper copy).doc Form and Instruction
NLM Reading Rooms Survey Fast Track ICR.doc Fast Track Submission Form IC Document

Information Collection (IC) Details

IC Title:	NLM Reading Rooms 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	Survey Screenshots	NLM Reading Room Survey (online version screen shots).pdf		Yes	Yes	Fillable Fileable
Form and Instruction	2	Survey (paper version)	NLM Reading Room Survey Instrument (paper copy).doc		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 269	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	269	269
Annual IC Time Burden (Hours)	22	22
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Fast Track Submission Form	NLM Reading Rooms Survey Fast Track ICR.doc	11/16/2015

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