NHLBI's Health Information Center (HIC)

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

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form 1 NHLBI's Health Information Center (HIC) Form and Instruction
1 Survey Instrument IVR Survey Instrument IVR_2016-05-15.docx Form and Instruction
2 Survey Instrument Web Questions Survey Instrument Web Questions_2016-05-16.docx Form and Instruction
FastTrack.doc Fast track HIC IC Document

Information Collection (IC) Details

IC Title:	NHLBI's Health Information Center (HIC)	Agency IC Tracking Number:

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	Survey Instrument IVR	Survey Instrument IVR_2016-05-15.docx		No		Paper Only
Form and Instruction	2	Survey Instrument Web Questions	Survey Instrument Web Questions_2016-05-16.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,255	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	20,900	20,900
Annual IC Time Burden (Hours)	1,372	1,372
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Fast track HIC	FastTrack.doc	06/14/2016

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