Implementation Science Consortium in Cancer Survey Form (NCI)

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NCI)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0642 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Implementation Science Consortium in Cancer Survey Form (NCI) Form
1 ISCC survey form ISCC Survey Form_v5.pdf Form
Fast Track ISCC Survey (3).docx Fast Track ISCC Survey IC Document

Information Collection (IC) Details

IC Title:	Implementation Science Consortium in Cancer Survey Form (NCI)	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	ISCC survey form	ISCC Survey Form_v5.pdf		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)	17	17
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Fast Track ISCC Survey	Fast Track ISCC Survey (3).docx	06/16/2020

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