Information Collection

Precision Medicine Survey Full Study

IC 220187 under ICR 201602-0925-012 · OMB 0925-0739.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0739 can be found here:

Documents and Forms

Document Name Document Type
Form 2 Precision Medicine Survey Full Study Form and Instruction
2 Attachment J NCI Precision Medicine Screenshots Attachment J-NCI Precision Medicine Screenshots.pdf Form and Instruction
Attach A Precision Medicine Survey.pdf Attachment A Precision Medicine Survey IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Precision Medicine Survey Full Study	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	2	Attachment J NCI Precision Medicine Screenshots	Attachment J-NCI Precision Medicine Screenshots.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 600	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	600	600
Annual IC Time Burden (Hours)	200	200
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment A Precision Medicine Survey	Attach A Precision Medicine Survey.pdf	02/19/2016

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