Information Collection

NHLBI's Health Information Center (HIC)

IC 221890 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⚠️ Notice: This information collection may be referencing outdated material.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 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

IC Title:

NHLBI's Health Information Center (HIC)

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 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 %

table that charts list of burden
	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

table that charts IC Documents
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.