Data and Safety Monitoring Meeting Evaluation (NIAMS)

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⚠️ Notice: This information collection may be referencing outdated material.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 Data and Safety Monitoring Meeting Evaluation (NIAMS) Form
1 NCR MB Survey screenshot NCR_MB Survey_Screenshots_2020_12_10.docx Form
KAI_Fast Track Template_2020_12_10_Updated.docx fast track survey for NCR MB IC Document

Information Collection (IC) Details

IC Title:	Data and Safety Monitoring Meeting Evaluation (NIAMS)	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	1	NCR MB Survey screenshot	NCR_MB Survey_Screenshots_2020_12_10.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	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	200	200
Annual IC Time Burden (Hours)	33	33
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
fast track survey for NCR MB	KAI_Fast Track Template_2020_12_10_Updated.docx	12/10/2020

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