NLM 4 Caregivers User 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⚠️ Notice: This information collection may be referencing outdated material.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 4 Caregivers User Survey Form and Instruction
1 NLM 4 Caregivers 2016 User Survey Instrument NLM 4 Caregivers 2016 User Survey Instrument.pdf Form and Instruction
NIH Fast Track ICR_NLM 4 Caregivers User Survey.doc NLM 4 Caregivers User Survey IC Document

Information Collection (IC) Details

IC Title:	NLM 4 Caregivers User 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	NLM 4 Caregivers 2016 User Survey Instrument	NLM 4 Caregivers 2016 User Survey Instrument.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 500	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	42	42
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
NLM 4 Caregivers User Survey	NIH Fast Track ICR_NLM 4 Caregivers User Survey.doc	11/03/2016

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