Information Collection

Assessments of Patient and Patient Advocate Experience with the FDA For Patients Website, Patient Listening Sessions, and Patient Affairs Staff Inquiry System

IC 236349 under ICR 201710-0910-006 · OMB 0910-0697.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0697 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix I - For Patients Website - Interview Guide - External Stakeholder.docx	Other-Patients Website - Interview G
Appendix II - Patient Listening Sessions - Interview Guide - External Stakeholder.docx	Other-Patient Listening Sessions - I
Appendix III - PAS Inquiry System - Questionnaire Webform.docx	Other-Survey
Appendix IV - PAS Inquiry System - Feedback Survey.docx	Other-Feedback
Appendix V - PAS Inquiry System - Questionnaire Webform Screenshot.docx	Other-Screenshot of Web Based Survey
0697 OMB Approval Memo PAS Inquiry System 2019.doc OMB Approval Memo	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Assessments of Patient and Patient Advocate Experience with the FDA For Patients Website, Patient Listening Sessions, and Patient Affairs Staff Inquiry System

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Patient Listening Sessions - Interview Guide	Appendix II - Patient Listening Sessions - Interview Guide - External Stakeholder.docx	Yes	Yes	Printable Only
Other-Survey	Appendix III - PAS Inquiry System - Questionnaire Webform.docx	Yes	Yes	Fillable Fileable
Other-Patients Website - Interview Guide	Appendix I - For Patients Website - Interview Guide - External Stakeholder.docx	Yes	Yes	Printable Only
Other-Feedback	Appendix IV - PAS Inquiry System - Feedback Survey.docx	Yes	Yes	Fillable Fileable
Other-Screenshot of Web Based Survey	Appendix V - PAS Inquiry System - Questionnaire Webform Screenshot.docx	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 142

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	142	142
Annual IC Time Burden (Hours)	66	66
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB Approval Memo	0697 OMB Approval Memo PAS Inquiry System 2019.doc	06/04/2019

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