Sub-Study #15: The Surveillance, Epidemiology, and End Results (SEER) Residual Tissue Repository Program: Survey to Assess Service Delivery and Product Quality

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

OMB: 0925-0642

IC ID: 203874

Information Collection (IC) Details

View Information Collection (IC)

Sub-Study #15: The Surveillance, Epidemiology, and End Results (SEER) Residual Tissue Repository Program: Survey to Assess Service Delivery and Product Quality
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 RTR Survey #15_Attach 3_RTR survey screenshots.pdf Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

72 9
   
Individuals or Households
 
   100 %

  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 72 0 0 0 0 0
Annual IC Time Burden (Hours) 6 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
#15_SEER RTR_Fast-Track_Request_8_17_2012 #15_SEER RTR_Fast-Track_Request_8_17_2012.doc 08/20/2012
#15_Attach 1_RTR survey Word #15_Attach 1_RTR survey Word.doc 08/20/2012
#15_Attach 2_RTR_Invitiation Letter #15_Attach 2_RTR_Invitiation Letter.doc 08/20/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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