Information Collection

Health Disparities Research Institute (HDRI) Course Assessment

IC 227469 under ICR 201602-0925-001 · OMB 0925-0740.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0740 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Health Disparities Research Institute (HDRI) Course Assessment Form
1 HDRI Assessment 2017 HDRI Assessment Modified.docx Form
HDRI Sub-Study Template Assessment NIH Wide Generic Modified.doc HDRI Sub-Study Template Assessment IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Health Disparities Research Institute (HDRI) Course Assessment	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	1	HDRI Assessment	2017 HDRI Assessment Modified.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 55	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	55	55
Annual IC Time Burden (Hours)	14	14
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
HDRI Sub-Study Template Assessment	HDRI Sub-Study Template Assessment NIH Wide Generic Modified.doc	07/12/2017

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