Information Collection

NLM Reading Rooms Satisfaction Survey

IC 218992 under ICR 201501-0925-004 · OMB 0925-0648.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 NLM Reading Rooms Satisfaction Survey	Form and Instruction
1 Survey Screenshots NLM Reading Room Survey (online version screen shots).pdf	Form and Instruction
2 Survey (paper version) NLM Reading Room Survey Instrument (paper copy).doc	Form and Instruction
NLM Reading Rooms Survey Fast Track ICR.doc Fast Track Submission Form	IC Document

IC Title:

NLM Reading Rooms Satisfaction Survey

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Survey Screenshots	NLM Reading Room Survey (online version screen shots).pdf		Yes	Yes	Fillable Fileable
Form and Instruction	2	Survey (paper version)	NLM Reading Room Survey Instrument (paper copy).doc		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 269

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	269	269
Annual IC Time Burden (Hours)	22	22
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast Track Submission Form	NLM Reading Rooms Survey Fast Track ICR.doc	11/16/2015

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