Form 1 Survey

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

OCHIN Web Survey screenshots

NIDDK Health Care Provider Satisfaction Survey

OMB: 0925-0648

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Burden Disclosure Statement

OMB 0925-0648
Exp.: 06/2024

Public reporting burden for this collection of information is estimated to average 3 minutes per response, including
the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and

An agency may not conduct or sponsor,
and a person is not required to respond to, a collection of information unless it
displays a currently valid OMB control number. Send comments regarding this burden estimate

completing and reviewing the collection of information.

or any other aspect of this collection of information, including suggestions for reducing this burden, to: NIH, Project
Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0648). Do not
return the completed form to this address.

All survey questions are optional, and participants may exit the survey at any time.

May 15, 2023

NIDDK

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