NIST Clinical Quality Assurance Program Impact and Needs Assessment Questionnaire

Generic Clearance for Program Evaluation Data Collections

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0693-0033 can be found here:

Documents and Forms

Document Name Document Type
0693-0033-NIST-QAP-Questionnaire-1-9-14.docx Other-Questionnaire
0693-0033-NIST-ClinicalQualityAssurance-Assessment-FourStandardSurveyQuestions-1-9-14.docx NIST ClinQAP Impact & Needs Assessment Questionniare - Supporting Statement IC Document

Information Collection (IC) Details

IC Title:	NIST Clinical Quality Assurance Program Impact and Needs Assessment Questionnaire	Agency IC Tracking Number:	DY

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Questionnaire			0693-0033-NIST-QAP-Questionnaire-1-9-14.docx		Yes	Yes	Fillable Fileable

Line of Business: General Science and Innovation

Subfunction: Scientific and Technological Research and Innovation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 250	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 75 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	250	250
Annual IC Time Burden (Hours)	63	63
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
NIST ClinQAP Impact & Needs Assessment Questionniare - Supporting Statement	0693-0033-NIST-ClinicalQualityAssurance-Assessment-FourStandardSurveyQuestions-1-9-14.docx	01/09/2014

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