BIRCWH Principal Investigator, Mentor, and Scholar Satisfaction Surveys

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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0643 can be found here:

Documents and Forms

Document Name Document Type
Form 1 BIRCWH Principal Investigator, Mentor, and Scholar Satisfaction Surveys Form and Instruction
1 Scholars Survey Attachment_A.1_NICHD_BIRCWH_Scholars_Survey_0925-0643.pdf Form and Instruction
2 Mentors Survey Attachment_A.2_NICHD_BIRCWH_Mentors_Survey_0925-0643.pdf Form and Instruction
3 PI Survey Attachment A.3__NICHD_BIRCWH_PI_Survey_0925-0643.pdf Form and Instruction
Fast-track template_NICHD_BIRCWH_0925-0643_revised.docx Fast-Track Template IC Document
Attachment_A.4_NICHD_BIRCWH_Email_Invite & Reminders_0925-0643.docx Survey Invitations IC Document

Information Collection (IC) Details

IC Title:	BIRCWH Principal Investigator, Mentor, and Scholar Satisfaction Surveys	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Scholars Survey	Attachment_A.1_NICHD_BIRCWH_Scholars_Survey_0925-0643.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	2	Mentors Survey	Attachment_A.2_NICHD_BIRCWH_Mentors_Survey_0925-0643.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	3	PI Survey	Attachment A.3__NICHD_BIRCWH_PI_Survey_0925-0643.pdf	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,970	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,970	2,970
Annual IC Time Burden (Hours)	990	990
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Fast-Track Template	Fast-track template_NICHD_BIRCWH_0925-0643_revised.docx	06/22/2015
Survey Invitations	Attachment_A.4_NICHD_BIRCWH_Email_Invite & Reminders_0925-0643.docx	06/22/2015

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