Website portal for Submission of Supplemental Evidence and Data for Systematic Reviews

Online Submission Form for Supplemental Evidence and Data for Systematic Reviews for the Evidence-based Practice Center Program

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0935-0231 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Website portal for Submission of Supplemental Evidence and Data for Systematic Reviews Form and Instruction
1 Attachment B -- Website portal for Submission of Supplem Attachment B --Online Submission Form.png Form and Instruction
2 Attachment C – Optional Data Entry Form Attachment C -- Optional_Data Entry Form.xlsx Form and Instruction

Information Collection (IC) Details

IC Title:	Website portal for Submission of Supplemental Evidence and Data for Systematic Reviews	Agency IC Tracking Number:

Is this a Common Form? No		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	Attachment B -- Website portal for Submission of Supplemental Evidence and Data for Systematic Reviews	Attachment B --Online Submission Form.png		Yes	Yes	Fillable Fileable
Form and Instruction	2	Attachment C – Optional Data Entry Form	Attachment C -- Optional_Data Entry Form.xlsx		No		Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 70	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	70	70
Annual IC Time Burden (Hours)	18	18
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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