Information Collection

Best Practices

IC 189057 under ICR 200802-0925-003 · OMB 0925-0590.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0590 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Best Practices	Form and Instruction
1 survey NCS-Questions.doc	Form and Instruction
GC-NCS.doc GC-NCS	IC Document
NCS-Cover Memo.doc NCS-Cover Memo	IC Document
3[1]. Attachment A- CHOP IRB Exempt Determination.doc 3[1]	IC Document
4[1]. Attachment B- Consent to Participate in a Research Study.rev.doc 4[1]	IC Document

IC Title:

Best Practices

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	survey	NCS-Questions.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 77

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	77	0	0	0	0	0
Annual IC Time Burden (Hours)	100	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
GC-NCS	GC-NCS.doc	04/28/2009
NCS-Cover Memo	NCS-Cover Memo.doc	04/28/2009
3[1]	3[1]. Attachment A- CHOP IRB Exempt Determination.doc	04/28/2009
4[1]	4[1]. Attachment B- Consent to Participate in a Research Study.rev.doc	04/28/2009

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