Basic electronic survey to inform development of a nursing research brochure (NINR)

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⚠️ Notice: This information collection may be referencing outdated material.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 Basic electronic survey to inform development of a nursing research brochure (NINR) Form and Instruction
1 NINR Survey instrument Appendix A_NINR Survey Instrument_updated.docx Form and Instruction
1 NINR Survey screenshots Appendix A_NINR Survey Screenshots_updated.pdf Form and Instruction
Fast Track_NINR Brochure_3_13_18.doc Fast Track NINR Brochure IC Document
Appendix B_Survey Invitation Email Screenshot_updated.pdf Survey Invitation Email screenshot IC Document

Information Collection (IC) Details

IC Title:	Basic electronic survey to inform development of a nursing research brochure (NINR)	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	NINR Survey instrument	Appendix A_NINR Survey Instrument_updated.docx		Yes	Yes	Fillable Fileable
Form and Instruction	1	NINR Survey screenshots	Appendix A_NINR Survey Screenshots_updated.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	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	100	100
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Fast Track NINR Brochure	Fast Track_NINR Brochure_3_13_18.doc	03/13/2018
Survey Invitation Email screenshot	Appendix B_Survey Invitation Email Screenshot_updated.pdf	03/13/2018

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