Information Collection

Financial Sustainability of Human Tissue Biobanking Survey

IC 207898 under ICR 201307-0925-005 · OMB 0925-0679.

Documents and Forms

Document Name Document Type
Form 1 Financial Sustainability of Human Tissue Biobanking Survey Form and Instruction
1 Biobanking Survey Attach1-Questionnaire Screen Shots-2.docx biobank-survey.healthcit.com Form and Instruction
Attach3-List_survey_questions.docx Attach3-List_survey_questions IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Financial Sustainability of Human Tissue Biobanking Survey	Agency IC Tracking Number:

Is this a Common Form? No		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
Form and Instruction	1	Biobanking Survey	Attach1-Questionnaire Screen Shots-2.docx	HTTP://biobank-survey.healthcit.com	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 548	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	548	548
Annual IC Time Burden (Hours)	822	822
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attach3-List_survey_questions	Attach3-List_survey_questions.docx	07/22/2013

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