Information Collection

National Survey of Organ Donation Attitudes and Practices

IC 6543 under ICR 201807-0915-001 · OMB 0915-0290.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0290 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1a National Survey of Organ Donation Attitudes and Practices	Form and Instruction
1a NSODAP CATI PHONE SCRIPT ENGLISH REV 6_28.pdf NSODAP CATI SCRIPT ENGLISH REV 6_28.pdf	Form and Instruction
1B NSODAP CATI PHONE SCRIPT SPANISH REV 6_28.pdf NSODAP CATI SCRIPT SPANISH REV 6_28.pdf	Form and Instruction
2a NSODAP ONLINE SCREENSHOTS ENGLISH REV 6_29.pdf NSODAP ONLINE SCREENSHOTS ENGLISH REV 6_29.pdf	Form
2b NSODAP ONLINE SCREENSHOTS SPANISH REV 6_28.pdf NSODAP ONLINE SCREENSHOTS SPANISH REV 6_28.pdf	Form
20180501 ChangesLastSurvey.docx Changes Last Survey	IC Document
20180501 National Survey Legislation.pdf Legislation	IC Document
20180501 National Survey Telephone Instrument REDLINE.docx National Survey Telephone Instructions REDLINE	IC Document
20180501 National Survey Telephone Survey Instructions.docx National Survey Telephone Survey Instructions	IC Document
20180501 National Survey Web Online Panel Instructions.docx National Survey Web Online Instructions	IC Document
CATI SCRIPT ENGLISH (1).RA.JKC CLEAN.pdf CATI Script ENGLISH	IC Document

IC Title:

National Survey of Organ Donation Attitudes and Practices

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1a	NSODAP CATI PHONE SCRIPT ENGLISH REV 6_28.pdf	NSODAP CATI SCRIPT ENGLISH REV 6_28.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	1B	NSODAP CATI PHONE SCRIPT SPANISH REV 6_28.pdf	NSODAP CATI SCRIPT SPANISH REV 6_28.pdf	Yes	Yes	Fillable Fileable
Form	2a	NSODAP ONLINE SCREENSHOTS ENGLISH REV 6_29.pdf	NSODAP ONLINE SCREENSHOTS ENGLISH REV 6_29.pdf	Yes	Yes	Fillable Fileable
Form	2b	NSODAP ONLINE SCREENSHOTS SPANISH REV 6_28.pdf	NSODAP ONLINE SCREENSHOTS SPANISH REV 6_28.pdf	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	10,000	10,000
Annual IC Time Burden (Hours)	2,900	2,900
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Changes Last Survey	20180501 ChangesLastSurvey.docx	07/06/2018
Legislation	20180501 National Survey Legislation.pdf	07/06/2018
National Survey Telephone Instructions REDLINE	20180501 National Survey Telephone Instrument REDLINE.docx	07/06/2018
National Survey Telephone Survey Instructions	20180501 National Survey Telephone Survey Instructions.docx	07/06/2018
National Survey Web Online Instructions	20180501 National Survey Web Online Panel Instructions.docx	07/06/2018
CATI Script ENGLISH	CATI SCRIPT ENGLISH (1).RA.JKC CLEAN.pdf	07/06/2018

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