Information Collection

Medicine: NIH Mind the Gap Webinar Series Survey II

IC 229947 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⚠️ Notice: This information collection may be referencing outdated material.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 Medicine: NIH Mind the Gap Webinar Series Survey II	Form
1 MtG Customer Satisfaction Survey - survey Monkey Scrensh 2018 MtG Customer Satisfaction Survey - Survey Monkey Screenshot v2.docx	Form
Fast Track Template 2018 - Mind the Gap Evaluation_01.31.18_Clean.doc Medicine: NIH Mind the Gap Webinar Series Survey II	IC Document

IC Title:

Medicine: NIH Mind the Gap Webinar Series Survey II

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	1	MtG Customer Satisfaction Survey - survey Monkey Screnshot	2018 MtG Customer Satisfaction Survey - Survey Monkey Screenshot v2.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 300

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

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

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	300	300
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Medicine: NIH Mind the Gap Webinar Series Survey II	Fast Track Template 2018 - Mind the Gap Evaluation_01.31.18_Clean.doc	02/02/2018

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