Information Collection

Sub-study #24 - Needs Assessment for the NCI Office of Cancer Survivorship's Web site (OCS)

IC 206546 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⚠️ Notice: This information collection may be referencing outdated material.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 1 Sub-study #24 - Needs Assessment for the NCI Office of Cancer Survivorship's Web site (OCS)	Form and Instruction
1 OCS Screener for Public OCS_#24_Attach1 Screener for Public_4-10-2013.doc	Form and Instruction
2 OCS Screener for Professionals OCS_#24_Attach3 Screener for Professionals_4-10-2013.docx	Form and Instruction
3 Facilitator's Guides for All Groups OCS_#24_Attach6 Facilitator's Guide All Audiences_4-10-2013.doc	Form and Instruction
Memo to OMB_Revisions to OCS.doc Memo to OMB_Revisions to OCS	IC Document
OCS Fast-Track_Request_#24_REV.doc OCS Fast-Track_Request_#24_REV	IC Document
OCS_#24_Attach2 Recruitment email_Profes_4-10-2013V.docx OCS_#24_Attach2 Recruitment email_Profes_4-10-2013V	IC Document
OCS_#24_Attach4 Consent_In-person_4-10-2013.docx OCS_#24_Attach4 Consent_In-person_4-10-2013	IC Document
OCS_#24_Attach5 Consent_Verbal Script_4-10-2013.docx OCS_#24_Attach5 Consent_Verbal Script_4-10-2013	IC Document
OCS_#24_Attach7 Email Reminder for Public_4-10-2013.docx OCS_#24_Attach7 Email Reminder for Public_4-10-2013	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Sub-study #24 - Needs Assessment for the NCI Office of Cancer Survivorship's Web site (OCS)

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	1	OCS Screener for Public	OCS_#24_Attach1 Screener for Public_4-10-2013.doc	No	No	Printable Only
Form and Instruction	2	OCS Screener for Professionals	OCS_#24_Attach3 Screener for Professionals_4-10-2013.docx	No	No	Printable Only
Form and Instruction	3	Facilitator's Guides for All Groups	OCS_#24_Attach6 Facilitator's Guide All Audiences_4-10-2013.doc	No	No	Printable Only

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: 120

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	120	0	0	0	0	0
Annual IC Time Burden (Hours)	66	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
Memo to OMB_Revisions to OCS	Memo to OMB_Revisions to OCS.doc	04/10/2013
OCS Fast-Track_Request_#24_REV	OCS Fast-Track_Request_#24_REV.doc	04/10/2013
OCS_#24_Attach2 Recruitment email_Profes_4-10-2013V	OCS_#24_Attach2 Recruitment email_Profes_4-10-2013V.docx	04/10/2013
OCS_#24_Attach4 Consent_In-person_4-10-2013	OCS_#24_Attach4 Consent_In-person_4-10-2013.docx	04/10/2013
OCS_#24_Attach5 Consent_Verbal Script_4-10-2013	OCS_#24_Attach5 Consent_Verbal Script_4-10-2013.docx	04/10/2013
OCS_#24_Attach7 Email Reminder for Public_4-10-2013	OCS_#24_Attach7 Email Reminder for Public_4-10-2013.docx	04/10/2013

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