Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Wellness Survey Questionns	Form	New	Available
Form 1 Childcare study survey	Form	New	Available
Form 2 listening session guiding questions	Form and Instruction	New	Available
Form 1 Screenshot from survey to inform Workshop discussion	Form	New	Available
Form 1 Healthcare Teams CD Survey	Form and Instruction	New	Available
Form 1 Service Now Survey	Form	New	Available
Form 1 NCIat Frederick-SciLibrary Survey 2018	Form	New	Available
Form 1 CPFP Grants Workshop Evaluation	Form	New	Available
Form 1 Screenshot for Media Survey	Form	New	Available
Form 1 6.1 Special Fitness Survey	Form	New	Available
Form 1 myNCI Hallway Interview Guide	Form and Instruction	New	Available
Form 1 Speaking About Science Workshop	Form	New	Available
Form 1 Focus Group Question	Form	New	Available
Form 1 IS Survey Screenshots	Form	New	Available
Form 1 Summer Curriculum Program Follow-Up Survey	Form	New	Available
Form 1 End of Course Summer Curriculum Survey	Form	New	Available
Form 1 CPFP NCI Summer Curriculum Daily Survey	Form	New	Available
Form 1 FRM Fellow Survey Form	Form	New	Available
Form 1 2018 NCORP Annual Meeting Planning Survey	Form	New	Available
Form 1 HINTS survey	Form	New	Available
Form 1 EGRP SeqSPACE Webinar Survey	Form	New	Available
Form 1 DCU Survey Screenshots	Form	New	Available
Form 2 CPF Survey 2018 Senior Fellows	Form and Instruction	New	Available
Form 1 CPF Survey 2018 First Year Fellows	Form and Instruction	New	Available
Form 1 EXPOSE Alumni Survey	Form	New	Available
Form 1 EXPOSE POST SURVEY	Form and Instruction	New	Available
Form 1 EXPOSE PRE-SURVEY	Form and Instruction	New	Available
Form 1 ASA24 User Survey	Form	New	Available
Form 1 SeqSPACE survey question screenshots	Form	New	Available
Form 1 screenshots - Survey Cohort Consortium	Form and Instruction	New	Available
Form 1 Shuttle Special	Form	New	Available
Form 1 Post Production Burden	Form and Instruction	New	Available
Form 1 Video Production Survey	Form and Instruction	New	Repair queued
Form 1 Scheduling Burden	Form and Instruction	New	Available
Form 1 EM Audio Visual Burden	Form and Instruction	New	Available
Form 1 2018 BRAIN PI meeting	Form	New	Available
Form 1 SPARC Survey Money Screenshots 2018 SPARC Symp Survey	Form and Instruction	New	Available
Form 1 Mockup Furniture Survey Card	Form and Instruction	New	Available
Form 1 2018 NCORP Annual Meeting Planning Survey	Form and Instruction	New	Available
Form 1 Lab relocation survey	Form	New	Available
Form 1 Express services survey	Form	New	Available
Form 1 Conference survey	Form	New	Available
Form 1 Fitness survey	Form	New	Available
Form 1 Small Little Job survey	Form	New	Available
Form 1 Data Collection Instrument	Form and Instruction	New	Available
Form 2 MGA Feedback Survey SITE Staff screenshots	Form	New	Available
Form 1 MGA Feedback Survey AUDIT Staff screenshots	Form	New	Available
Form 1 2nd RAS survey questions	Form	New	Available
Form 1 CBIIT Soultions Survey	Form	New	Available
Form 1 HDRP Survey	Form	New	Available
Form 1 CBIIT Survey Screenshots	Form	New	Available
Form 1 Survey	Form	New	Available
Form 1 Post-Event Survey: NCI Healthcare Teams Cyberdiscussion: Feedback	Form	New	Available
Form 3 Clinical Trials Search Survey	Form	New	Available
Form 2 Exit Survey	Form	New	Available
Form 1 Page Level Surey	Form	New	Available
Form 4 Content WRX Survey	Form	New	Available
Form 1 Survey	Form	New	Available
Form 1 CBIIT Event Survey	Form	New	Available
Form 1 SurveyMonkey for NCORP	Form	New	Available
Form 1 Shuttle Survey	Form	New	Available
Form 1 Customer Survey	Form	New	Available
SSA NCI Fast Track.docx	Supporting Statement A	Uploaded 2017-03-07	Available
30dayFRN2017-04254.pdf	Supplementary Document	Uploaded 2017-03-07	Available
Attachment 2.docx	Supplementary Document	Uploaded 2017-02-16	Available
Attachment 1.doc	Supplementary Document	Uploaded 2017-02-16	Available
SSB NCI Fast Track.docx	Supporting Statement B	Uploaded 2017-02-16	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
235381	Information Gathering for Employee Wellness Program Needs (NCI)	Form	New	Wellness Survey Questionns
234752	Child Care Needs Survey (NCI)	Form	New	Childcare study survey
234752	Child Care Needs Survey (NCI)	Form and Instruction	New	listening session guiding questions
234735	Feedback Survey Regarding Current State of Systems Science Approaches in Epidemiological Research	Form	New	Screenshot from survey to inform Workshop discussion
234680	Healthcare Teams Cyber Discussion Feedback Survey (NCI)	Form and Instruction	New	Healthcare Teams CD Survey
234408	CBIIT Service Now Customer Satisfaction Survey (NCI)	Form	New	Service Now Survey
234354	Scientific Library Support Survey at the National Cancer Institute at Frederick (NCI)	Form	New	NCIat Frederick-SciLibrary Survey 2018
234180	Grants and Grantsmanship Workshop Survey	Form	New	CPFP Grants Workshop Evaluation
234177	Requirement Gather for Media at National Cancer Institute (NCI) at Frederick Contract	Form	New	Screenshot for Media Survey
234118	Office of Space Facilities and Management (OFSM) Customer Satisfaction Survey/Focus Group Fitness Center (NCI)	Form	New	6.1 Special Fitness Survey
234093	Hallway Interviews about myNCI with NCI staff (NCI)	Form and Instruction	New	myNCI Hallway Interview Guide
233462	Cancer Prevention Fellowship Program (CPFP) Speaking About Science Workshop Survey (NCI)	Form	New	Speaking About Science Workshop
233058	NCI CPFP Summer Curriculum Focus Group Survey	Form	New	Focus Group Question
233018	Implementation Science (IS) at a Glance (NCI)	Form	New	IS Survey Screenshots
232953	NCI CPFP Follow-Up Summer Curriculum Survey	Form	New	Summer Curriculum Program Follow-Up Survey
232927	NCI CPFP End of Course Summer Curriculum Survey	Form	New	End of Course Summer Curriculum Survey
232895	NCI CPFP Daily Summer Curriculum Survey	Form	New	CPFP NCI Summer Curriculum Daily Survey
232893	Cancer Prevention Fellowship Program (CPFP) Fellows Research Meeting (FRM) Speaker Survey (NCI)	Form	New	FRM Fellow Survey Form
232828	2018 NCORP Annual Meeting Assessment and Feedback (NCI)	Form	New	2018 NCORP Annual Meeting Planning Survey
232807	Assessment of 2018 HINTS Data Users Conference (NCI)	Form	New	HINTS survey
232684	Epidemiology and Genomics Research Program (EGRP) SeqSPACE Webinar Poll (NCI)	Form	New	EGRP SeqSPACE Webinar Survey
232300	NCI Digital Communications University (DCU) Survey	Form	New	DCU Survey Screenshots
232218	Cancer Prevention Fellowship Program (CPFP) Fellows by Fellows Annual Survey (NCI)	Form and Instruction	New	CPF Survey 2018 Senior Fellows
232218	Cancer Prevention Fellowship Program (CPFP) Fellows by Fellows Annual Survey (NCI)	Form and Instruction	New	CPF Survey 2018 First Year Fellows
232110	EXPOSE Alumni Survey Fast track (NCI)	Form	New	EXPOSE Alumni Survey
232107	NCI Explore On Site (EXPOSE) Pre-and Post- Customer Satisfaction Survey	Form and Instruction	New	EXPOSE POST SURVEY
232107	NCI Explore On Site (EXPOSE) Pre-and Post- Customer Satisfaction Survey	Form and Instruction	New	EXPOSE PRE-SURVEY
231817	ASA24 Customer Satisfaction Survey (NCI)	Form	New	ASA24 User Survey
231794	Epidemiology and Genomics Research Program (EGRP) SeqSPACE Webinar Survey	Form	New	SeqSPACE survey question screenshots
231476	Pre-meeting Survey for the NCI Cohort Consortium	Form and Instruction	New	screenshots - Survey Cohort Consortium
231320	NCI OFSM Shuttle Special Service	Form	New	Shuttle Special
231134	NIH Events Management – Post Production Survey	Form and Instruction	New	Post Production Burden
231125	NIH Events Management – Video Production Survey	Form and Instruction	New	Video Production Survey
231124	NIH Events Management – Scheduling Services Survey	Form and Instruction	New	Scheduling Burden
231123	NIH Events Management – Audio Visual Survey	Form and Instruction	New	EM Audio Visual Burden
231107	2018 Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Investigators Meeting Post-Conference Feedback Survey	Form	New	2018 BRAIN PI meeting
231106	Participant Feedback on 2018 NIH Common Fund Stimulating Peripheral Activity to Relieve Conditions (SPARC) Research Program Annual Awardee Meeting	Form and Instruction	New	SPARC Survey Money Screenshots 2018 SPARC Symp Survey
230939	Rockledge 1 and 2 Furniture Mockup Feedback	Form and Instruction	New	Mockup Furniture Survey Card
230862	2018 NCORP Annual Meeting Pre- Meeting Evaluation and Feedback	Form and Instruction	New	2018 NCORP Annual Meeting Planning Survey
230790	NCI OSFM Relocation Survey - Lab	Form	New	Lab relocation survey
230789	NCI OSFM Express Services Survey	Form	New	Express services survey
230788	NCI OSFM Conference Room Services Survey	Form	New	Conference survey
230785	NCI OSFM Fitness Center Survey	Form	New	Fitness survey
230782	NCI OSFM Small Little Job (SLJ) Survey	Form	New	Small Little Job survey
230775	NCI OSFM Relocation Survey- Office	Form and Instruction	New	Data Collection Instrument
230057	CTSU Multi-Group Audit (MGA) Feedback Surveys	Form	New	MGA Feedback Survey SITE Staff screenshots
230057	CTSU Multi-Group Audit (MGA) Feedback Surveys	Form	New	MGA Feedback Survey AUDIT Staff screenshots
229810	2nd RAS Initiative Symposium Feedback Survey	Form	New	2nd RAS survey questions
229239	Customer Satisfaction Surveys for CBIIT Solutions Website	Form	New	CBIIT Soultions Survey
229112	Healthcare Delivery Research Program Communications Evaluation Survey	Form	New	HDRP Survey
228803	Voice of Customer (VoC) Surveys for CBITT's Website	Form	New	CBIIT Survey Screenshots
228535	Survey of Customer Satisfaction for DCCPS Fellows	Form	New	Survey
228406	NCI Healthcare Teams Cyber Discussion Feedback Survey	Form	New	Post-Event Survey: NCI Healthcare Teams Cyberdiscussion: Feedback
228151	voice of Customer (VoC) surveys for NCI's cancer.gov	Form	New	Clinical Trials Search Survey
228151	voice of Customer (VoC) surveys for NCI's cancer.gov	Form	New	Exit Survey
228151	voice of Customer (VoC) surveys for NCI's cancer.gov	Form	New	Page Level Surey
228151	voice of Customer (VoC) surveys for NCI's cancer.gov	Form	New	Content WRX Survey
228043	Customer Satisfaction Survey for CBIIT's Newsletter and Intranet	Form	New	Survey
228029	Customer Satisfaction Survey for CBIIT Events	Form	New	CBIIT Event Survey
227901	2017 NCORP Annual Meeting Assessment and Feedback	Form	New	SurveyMonkey for NCORP
227788	NCI OFSM Customer Satisfaction Survey	Form	New	Shuttle Survey
227333	NCEF Survey for Program Operations	Form	New	Customer Survey

ICR Details

OMB Control No: 0925-0642	ICR Reference No: 201702-0925-001
Status: Historical Active	Previous ICR Reference No: 201406-0925-004
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/02/2017
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/08/2017
Terms of Clearance: OMB approves this collection for a period of three years. To request approval of information collections under this generic approval, the agency must do the following: 1) Unless an agency is using multiple modes of collection (e.g., paper forms and electronic submissions), provide a Generic Clearance Submission Template for each Instrument; 2) If the agency is using multiple modes of collection (e.g., paper forms and electronic submissions), the same Generic Clearance Submission Template may be used for both instruments; 3) each Generic Clearance Submission Template must be uploaded as a Supplementary document using a naming convention that allows the public to identify the associated instrument; 4) submit no more than five Generic Submission Templates with each request.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2020	36 Months From Approved	08/31/2017
Responses	49,500	0	19,500
Time Burden (Hours)	26,751	0	26,250
Cost Burden (Dollars)	0	0	0

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Abstract: This generic has provided information about the National Cancer Institute’s customer or stakeholder perceptions, experiences and expectations, provide an early warning of issues with service, or focus attention on areas where communication, training or changes in operations might improve delivery of products or services. It has also allowed feedback to contribute directly to the improvement of program management. Feedback collected under this generic clearance provides useful information but it does not yield data that can be generalized to the overall population.

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Authorizing Statute(s): EO: EO 12862 Name/Subject of EO: SETTING CUSTOMER SERVICE STANDARDS
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 89954	12/13/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 12616	03/06/2017
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 55

table that charts list of burden

IC Title	Form No.	Form Name
2017 NCORP Annual Meeting Assessment and Feedback	1	SurveyMonkey for NCORP
2018 Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Investigators Meeting Post-Conference Feedback Survey	1	2018 BRAIN PI meeting
2018 NCORP Annual Meeting Assessment and Feedback (NCI)	1	2018 NCORP Annual Meeting Planning Survey
2018 NCORP Annual Meeting Pre- Meeting Evaluation and Feedback	1	2018 NCORP Annual Meeting Planning Survey
2nd RAS Initiative Symposium Feedback Survey	1	2nd RAS survey questions
ASA24 Customer Satisfaction Survey (NCI)	1	ASA24 User Survey
Assessment of 2018 HINTS Data Users Conference (NCI)	1	HINTS survey
CBIIT Service Now Customer Satisfaction Survey (NCI)	1	Service Now Survey
CTSU Multi-Group Audit (MGA) Feedback Surveys	1, 2	MGA Feedback Survey AUDIT Staff screenshots ,   MGA Feedback Survey SITE Staff screenshots
Cancer Prevention Fellowship Program (CPFP) Fellows Research Meeting (FRM) Speaker Survey (NCI)	1	FRM Fellow Survey Form
Cancer Prevention Fellowship Program (CPFP) Fellows by Fellows Annual Survey (NCI)	1, 2	CPF Survey 2018 First Year Fellows ,   CPF Survey 2018 Senior Fellows
Cancer Prevention Fellowship Program (CPFP) Speaking About Science Workshop Survey (NCI)	1	Speaking About Science Workshop
Child Care Needs Survey (NCI)	2, 1	Childcare study survey ,   listening session guiding questions
Customer Satisfaction Survey for CBIIT Events	1	CBIIT Event Survey
Customer Satisfaction Survey for CBIIT's Newsletter and Intranet	1	Survey
Customer Satisfaction Surveys for CBIIT Solutions Website	1	CBIIT Soultions Survey
EXPOSE Alumni Survey Fast track (NCI)	1	EXPOSE Alumni Survey
Epidemiology and Genomics Research Program (EGRP) SeqSPACE Webinar Poll (NCI)	1	EGRP SeqSPACE Webinar Survey
Epidemiology and Genomics Research Program (EGRP) SeqSPACE Webinar Survey	1	SeqSPACE survey question screenshots
Feedback Survey Regarding Current State of Systems Science Approaches in Epidemiological Research	1	Screenshot from survey to inform Workshop discussion
Grants and Grantsmanship Workshop Survey	1	CPFP Grants Workshop Evaluation
Hallway Interviews about myNCI with NCI staff (NCI)	1	myNCI Hallway Interview Guide
Healthcare Delivery Research Program Communications Evaluation Survey	1	HDRP Survey
Healthcare Teams Cyber Discussion Feedback Survey (NCI)	1	Healthcare Teams CD Survey
Implementation Science (IS) at a Glance (NCI)	1	IS Survey Screenshots
Information Gathering for Employee Wellness Program Needs (NCI)	1	Wellness Survey Questionns
NCEF Survey for Program Operations	1	Customer Survey
NCI CPFP Daily Summer Curriculum Survey	1	CPFP NCI Summer Curriculum Daily Survey
NCI CPFP End of Course Summer Curriculum Survey	1	End of Course Summer Curriculum Survey
NCI CPFP Follow-Up Summer Curriculum Survey	1	Summer Curriculum Program Follow-Up Survey
NCI CPFP Summer Curriculum Focus Group Survey	1	Focus Group Question
NCI Digital Communications University (DCU) Survey	1	DCU Survey Screenshots
NCI Explore On Site (EXPOSE) Pre-and Post- Customer Satisfaction Survey	1, 1	EXPOSE PRE-SURVEY ,   EXPOSE POST SURVEY
NCI Healthcare Teams Cyber Discussion Feedback Survey	1	Post-Event Survey: NCI Healthcare Teams Cyberdiscussion: Feedback
NCI OFSM Customer Satisfaction Survey	1	Shuttle Survey
NCI OFSM Shuttle Special Service	1	Shuttle Special
NCI OSFM Conference Room Services Survey	1	Conference survey
NCI OSFM Express Services Survey	1	Express services survey
NCI OSFM Fitness Center Survey	1	Fitness survey
NCI OSFM Relocation Survey - Lab	1	Lab relocation survey
NCI OSFM Relocation Survey- Office	1	Data Collection Instrument
NCI OSFM Small Little Job (SLJ) Survey	1	Small Little Job survey
NIH Events Management – Audio Visual Survey	1	EM Audio Visual Burden
NIH Events Management – Post Production Survey	1	Post Production Burden
NIH Events Management – Scheduling Services Survey	1	Scheduling Burden
NIH Events Management – Video Production Survey	1	Video Production Survey
Office of Space Facilities and Management (OFSM) Customer Satisfaction Survey/Focus Group Fitness Center (NCI)	1	6.1 Special Fitness Survey
Participant Feedback on 2018 NIH Common Fund Stimulating Peripheral Activity to Relieve Conditions (SPARC) Research Program Annual Awardee Meeting	1	SPARC Survey Money Screenshots 2018 SPARC Symp Survey
Pre-meeting Survey for the NCI Cohort Consortium	1	screenshots - Survey Cohort Consortium
Requirement Gather for Media at National Cancer Institute (NCI) at Frederick Contract	1	Screenshot for Media Survey
Rockledge 1 and 2 Furniture Mockup Feedback	1	Mockup Furniture Survey Card
Scientific Library Support Survey at the National Cancer Institute at Frederick (NCI)	1	NCIat Frederick-SciLibrary Survey 2018
Survey of Customer Satisfaction for DCCPS Fellows	1	Survey
Voice of Customer (VoC) Surveys for CBITT's Website	1	CBIIT Survey Screenshots
voice of Customer (VoC) surveys for NCI's cancer.gov	1, 2, 3, 4	Page Level Surey ,   Exit Survey ,   Clinical Trials Search Survey ,   Content WRX Survey

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	49,500	19,500	0	30,000	0	0
Annual Time Burden (Hours)	26,751	26,250	0	501	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a revision. The changes proposed in this information collection revolve around the burden. The overall burden has increased by 167 hours. This is the difference of the previously approved 8,750 minus the proposed, 8,917. The total number of respondents has increased by 10,000 from 6,500 to 16,500. This increase is to account for for the increased survey activities that are planned. The overall 3 year burden has increased by 501.

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Annual Cost to Federal Government: $300,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 03/08/2017

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