National Institute of Mental Health (NIMH) Professional Coalition for Research Progress Meeting Assessment Form

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⚠️ Notice: This information collection may be referencing outdated material.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 National Institute of Mental Health (NIMH) Professional Coalition for Research Progress Meeting Assessment Form Form and Instruction
1 NIMH Professional Coalition for Research Progress Meetin NIMH Professional Coalition for Research Progress Meeting Assessment Form for OMB Clearance.doc Form and Instruction
Request for OMB Clearance - Collection of Routine Customer Feedback (NIMH Coalition Meeting).docx National Institute of Mental Health (NIMH) Professional Coalition for Research Progress Meeting Assessment Form IC Document

Information Collection (IC) Details

IC Title:	National Institute of Mental Health (NIMH) Professional Coalition for Research Progress Meeting Assessment Form	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 Professional Coalition for Research Progress Meeting Assessment Form	NIMH Professional Coalition for Research Progress Meeting Assessment Form for OMB Clearance.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 65	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	65	65
Annual IC Time Burden (Hours)	2	2
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
National Institute of Mental Health (NIMH) Professional Coalition for Research Progress Meeting Assessment Form	Request for OMB Clearance - Collection of Routine Customer Feedback (NIMH Coalition Meeting).docx	03/13/2018

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