Information Collection

Bundled Sub-studies #5 DCP Survey, #6 R2R Survey, and #7 PS-OC Survey

IC 201419 under ICR 201108-0925-002 · OMB 0925-0642.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3E Bundled Sub-studies #5 DCP Survey, #6 R2R Survey, and #7 PS-OC Survey	Form and Instruction
1 DCP Survey Screenshots #5_Attach 2_DCP_Survey_Screenshots.pdf	Form and Instruction
2 R2R Survey #6_Attach 1_R2R Survey _Screenshots_1-30-12.docx	Form and Instruction
3A #7_Attach 2A_Administrators #7_OSPO_Attach 2A_Administrators (Section A).pdf	Form and Instruction
3B #7_Attach2B_Education #7_OSPO_Attach 2B_Education and Training Unit Leaders (Sections A and E).pdf	Form and Instruction
3C #7_Attach2C_Principal #7_OSPO_Attach 2C_Principal and Scientific Investigators (Sections B & J).pdf	Form and Instruction
3D #7_Attach2D_Project Investigators #7_OSPO_Attach 2D_Project Investigators (Sections C & J).pdf	Form and Instruction
3E #7_Attach2E_Outreach #7_OSPO_Attach 2E_Outreach and Education Unit Leaders (Section D).pdf	Form and Instruction
3F #7_Attach2F_Advocates #7_OSPO_Attach 2F_Advocates (Section F).pdf	Form and Instruction
3H #7_Attach2H_Trainees #7_OSPO_Attach 2H_Trainees (Sections H &J).pdf	Form and Instruction
3G #7_Attach2G_Advisors #7_OSPO_Attach 2G_External Advisors & Scientists Not Associated (Section G).pdf	Form and Instruction
Fast-Track Request_#5_DCP.docx #5 Fast Track Request DCP	IC Document
#5_Attach 1_DCP_invite.docx #5_Attach 1_DCP_invite	IC Document
#7_OSPO_Attach 1_ Invite Letter.docx #7_OSPO_Attach 1_ Invite Letter	IC Document
Memo to OMB_Key To Bundled #5, #6, and #7.doc Summary Memo	IC Document
Fast-Track Request_#7_OPSO_2-24-2012.docx Fast-Track Request #7_OSPO	IC Document
Fast-Track Request_#6_R2R_2-24-12.docx Fast-Track Request #6_R2R	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Bundled Sub-studies #5 DCP Survey, #6 R2R Survey, and #7 PS-OC Survey

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	3E	#7_Attach2E_Outreach	#7_OSPO_Attach 2E_Outreach and Education Unit Leaders (Section D).pdf	Yes	Yes	Fillable Fileable
Form and Instruction	3F	#7_Attach2F_Advocates	#7_OSPO_Attach 2F_Advocates (Section F).pdf	Yes	Yes	Fillable Fileable
Form and Instruction	3B	#7_Attach2B_Education	#7_OSPO_Attach 2B_Education and Training Unit Leaders (Sections A and E).pdf	Yes	Yes	Fillable Fileable
Form and Instruction	3C	#7_Attach2C_Principal	#7_OSPO_Attach 2C_Principal and Scientific Investigators (Sections B & J).pdf	Yes	Yes	Fillable Fileable
Form and Instruction	3D	#7_Attach2D_Project Investigators	#7_OSPO_Attach 2D_Project Investigators (Sections C & J).pdf	Yes	Yes	Fillable Printable
Form and Instruction	1	DCP Survey Screenshots	#5_Attach 2_DCP_Survey_Screenshots.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	2	R2R Survey	#6_Attach 1_R2R Survey _Screenshots_1-30-12.docx	Yes	Yes	Fillable Fileable
Form and Instruction	3A	#7_Attach 2A_Administrators	#7_OSPO_Attach 2A_Administrators (Section A).pdf	Yes	Yes	Fillable Fileable
Form and Instruction	3H	#7_Attach2H_Trainees	#7_OSPO_Attach 2H_Trainees (Sections H &J).pdf	Yes	Yes	Fillable Fileable
Form and Instruction	3G	#7_Attach2G_Advisors	#7_OSPO_Attach 2G_External Advisors & Scientists Not Associated (Section G).pdf	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title: SORN #09-25-0156, "Records of Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public Health Service, HHS/PHS/NIH/OD"

FR Citation: 67 FR 60743

Number of Respondents: 2,217

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

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	2,217	0	0	0	0	0
Annual IC Time Burden (Hours)	351	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
#5 Fast Track Request DCP	Fast-Track Request_#5_DCP.docx	02/16/2012
#5_Attach 1_DCP_invite	#5_Attach 1_DCP_invite.docx	02/16/2012
#7_OSPO_Attach 1_ Invite Letter	#7_OSPO_Attach 1_ Invite Letter.docx	02/16/2012
Summary Memo	Memo to OMB_Key To Bundled #5, #6, and #7.doc	02/24/2012
Fast-Track Request #7_OSPO	Fast-Track Request_#7_OPSO_2-24-2012.docx	02/24/2012
Fast-Track Request #6_R2R	Fast-Track Request_#6_R2R_2-24-12.docx	02/24/2012

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