Form 1 Survey Mock-up

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

Survey Mock Up for PRA Submission-08-21-20

ClinRegs Pop-up Survey Questions (NIAID)

OMB: 0925-0668

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Pop-Up Question 1.
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Has ClinRegs saved you time?

Yes
No
Please specify:

OMB Control #: 0925-0668; Expiration Date: 4/30/2022

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Burden Disclosure: Public reporting burden for this collection of information is
estimated to average 1 minute per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. An agency may
not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. Send comments
regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705
Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA# 0925-0668. Do not
return the completed form to this address.

Pop-Up Question 1.
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i

x Close

Thank you for your feedback!

OMB Control #: 0925-0668; Expiration Date: 4/30/2022

i

Close

Burden Disclosure: Public reporting burden for this collection of information is
estimated to average 1 minute per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. An agency may
not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. Send comments
regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705
Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA# 0925-0668. Do not
return the completed form to this address.

Pop-Up Question 2.
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Did you find the information you needed?

x Close

Yes
No
Please specify:

OMB Control #: 0925-0668; Expiration Date: 4/30/2022

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Burden Disclosure: Public reporting burden for this collection of information is
estimated to average 1 minute per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. An agency may
not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. Send comments
regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705
Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA# 0925-0668. Do not
return the completed form to this address.

Pop-Up Question 2.
Burden disclosure displayed when user clicks on or hovers over

i

x Close

Thank you for your feedback!

OMB Control #: 0925-0668; Expiration Date: 4/30/2022

i

Close

Burden Disclosure: Public reporting burden for this collection of information is
estimated to average 1 minute per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. An agency may
not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. Send comments
regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705
Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA# 0925-0668. Do not
return the completed form to this address.

Pop-Up Question 3.
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i

Would you recommend ClinRegs to
your colleagues?

x Close

Yes
No
Please specify:

OMB Control #: 0925-0668; Expiration Date: 4/30/2022

i

Submit

Burden Disclosure: Public reporting burden for this collection of information is
estimated to average 1 minute per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. An agency may
not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. Send comments
regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705
Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA# 0925-0668. Do not
return the completed form to this address.

Pop-Up Question 3.
Burden disclosure displayed when user clicks on or hovers over

i

x Close

Thank you for your feedback!

OMB Control #: 0925-0668; Expiration Date: 4/30/2022

i

Close

Burden Disclosure: Public reporting burden for this collection of information is
estimated to average 1 minute per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. An agency may
not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. Send comments
regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705
Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA# 0925-0668. Do not
return the completed form to this address.

Pop-Up Question 4.
Burden disclosure displayed when user clicks on or hovers over

i

Do you need to compare information
between more than two countries?

x Close

Yes
No
Please specify:

OMB Control #: 0925-0668; Expiration Date: 4/30/2022

i

Submit

Burden Disclosure: Public reporting burden for this collection of information is
estimated to average 1 minute per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. An agency may
not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. Send comments
regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705
Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA# 0925-0668. Do not
return the completed form to this address.

Pop-Up Question 4.
Burden disclosure displayed when user clicks on or hovers over

i

x Close

Thank you for your feedback!

OMB Control #: 0925-0668; Expiration Date: 4/30/2022

i

Close

Burden Disclosure: Public reporting burden for this collection of information is
estimated to average 1 minute per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. An agency may
not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. Send comments
regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705
Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA# 0925-0668. Do not
return the completed form to this address.

Pop-Up Question 5.
Burden disclosure displayed when user clicks on or hovers over

i

Are there regulatory topics you would like
added to ClinRegs?

x Close

Yes
No
Please specify:

OMB Control #: 0925-0668; Expiration Date: 4/30/2022

i

Submit

Burden Disclosure: Public reporting burden for this collection of information is
estimated to average 1 minute per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. An agency may
not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. Send comments
regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705
Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA# 0925-0668. Do not
return the completed form to this address.

Pop-Up Question 5.
Burden disclosure displayed when user clicks on or hovers over

i

x Close

Thank you for your feedback!

OMB Control #: 0925-0668; Expiration Date: 4/30/2022

i

Close

Burden Disclosure: Public reporting burden for this collection of information is
estimated to average 1 minute per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. An agency may
not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. Send comments
regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705
Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA# 0925-0668. Do not
return the completed form to this address.

Pop-Up Question 6.
Burden disclosure displayed when user clicks on or hovers over

i

Do you know about the share button on
the right side of the page?

x Close

Yes
No
OMB Control #: 0925-0668; Expiration Date: 4/30/2022

i

Submit

Burden Disclosure: Public reporting burden for this collection of information is
estimated to average 1 minute per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. An agency may
not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. Send comments
regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705
Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA# 0925-0668. Do not
return the completed form to this address.

Pop-Up Question 6.
Burden disclosure displayed when user clicks on or hovers over

i

x Close

Thank you for your feedback!

OMB Control #: 0925-0668; Expiration Date: 4/30/2022

i

Close

Burden Disclosure: Public reporting burden for this collection of information is
estimated to average 1 minute per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. An agency may
not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. Send comments
regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705
Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA# 0925-0668. Do not
return the completed form to this address.

Pop-Up Question 7.
Burden disclosure displayed when user clicks on or hovers over

i

Do you know about the print button on
the right side of the page?

x Close

Yes
No
OMB Control #: 0925-0668; Expiration Date: 4/30/2022

i

Submit

Burden Disclosure: Public reporting burden for this collection of information is
estimated to average 1 minute per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. An agency may
not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. Send comments
regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705
Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA# 0925-0668. Do not
return the completed form to this address.

Pop-Up Question 7.
Burden disclosure displayed when user clicks on or hovers over

i

x Close

Thank you for your feedback!

OMB Control #: 0925-0668; Expiration Date: 4/30/2022

i

Close

Burden Disclosure: Public reporting burden for this collection of information is
estimated to average 1 minute per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. An agency may
not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. Send comments
regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705
Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA# 0925-0668. Do not
return the completed form to this address.

Pop-Up Question 8.
Burden disclosure displayed when user clicks on or hovers over

i

Do you know about the comment button
on the right side of the page?

x Close

Yes
No
OMB Control #: 0925-0668; Expiration Date: 4/30/2022

i

Submit

Burden Disclosure: Public reporting burden for this collection of information is
estimated to average 1 minute per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. An agency may
not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. Send comments
regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705
Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA# 0925-0668. Do not
return the completed form to this address.

Pop-Up Question 8.
Burden disclosure displayed when user clicks on or hovers over

i

x Close

Thank you for your feedback!

OMB Control #: 0925-0668; Expiration Date: 4/30/2022

i

Close

Burden Disclosure: Public reporting burden for this collection of information is
estimated to average 1 minute per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. An agency may
not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. Send comments
regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705
Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA# 0925-0668. Do not
return the completed form to this address.

Pop-Up Question 9.
Burden disclosure displayed when user clicks on or hovers over

i

Do you know you can sign up to receive
ClinRegs updates using subscribe button
on the top of the page?

x Close

Yes
No
OMB Control #: 0925-0668; Expiration Date: 4/30/2022

i

Submit

Burden Disclosure: Public reporting burden for this collection of information is
estimated to average 1 minute per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. An agency may
not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. Send comments
regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705
Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA# 0925-0668. Do not
return the completed form to this address.

Pop-Up Question 9.
Burden disclosure displayed when user clicks on or hovers over

i

x Close

Thank you for your feedback!

OMB Control #: 0925-0668; Expiration Date: 4/30/2022

i

Close

Burden Disclosure: Public reporting burden for this collection of information is
estimated to average 1 minute per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. An agency may
not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. Send comments
regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705
Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA# 0925-0668. Do not
return the completed form to this address.

Pop-Up Question 10.
Burden disclosure displayed when user clicks on or hovers over

i

Did you know you can view ClinRegs in a
different language using the translate
feature at the top of the page?

x Close

Yes
No
OMB Control #: 0925-0668; Expiration Date: 4/30/2022

i

Submit

Burden Disclosure: Public reporting burden for this collection of information is
estimated to average 1 minute per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. An agency may
not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. Send comments
regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705
Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA# 0925-0668. Do not
return the completed form to this address.

Pop-Up Question 10.
Burden disclosure displayed when user clicks on or hovers over

i

x Close

Thank you for your feedback!

OMB Control #: 0925-0668; Expiration Date: 4/30/2022

i

Close

Burden Disclosure: Public reporting burden for this collection of information is
estimated to average 1 minute per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. An agency may
not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. Send comments
regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705
Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA# 0925-0668. Do not
return the completed form to this address.

Pop-Up Question 11.
Burden disclosure displayed when user clicks on or hovers over

i

x Close

What is your primary organizational affiliation?
NIAID
NIH (non-NIAID)
US Government, Other
Industry
Academia
Not-for-Profit

Other
OMB Control #: 0925-0668; Expiration Date: 4/30/2022

i

Submit

Burden Disclosure: Public reporting burden for this collection of information is
estimated to average 1 minute per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. An agency may
not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. Send comments
regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705
Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA# 0925-0668. Do not
return the completed form to this address.

Pop-Up Question 11.
Burden disclosure displayed when user clicks on or hovers over

i

x Close

Thank you for your feedback!

OMB Control #: 0925-0668; Expiration Date: 4/30/2022

i

Close

Burden Disclosure: Public reporting burden for this collection of information is
estimated to average 1 minute per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. An agency may
not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. Send comments
regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705
Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA# 0925-0668. Do not
return the completed form to this address.

Pop-Up Question 12.
Burden disclosure displayed when user clicks on or hovers over

i

Are you involved in NIAID-funded clinical
research (for example: grantee, contractor,
partner, clinical trials network, etc.)?

x Close

Yes
No
OMB Control #: 0925-0668; Expiration Date: 4/30/2022

i

Submit

Burden Disclosure: Public reporting burden for this collection of information is
estimated to average 1 minute per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. An agency may
not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. Send comments
regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705
Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA# 0925-0668. Do not
return the completed form to this address.

Pop-Up Question 12.
Burden disclosure displayed when user clicks on or hovers over

i

x Close

Thank you for your feedback!

OMB Control #: 0925-0668; Expiration Date: 4/30/2022

i

Close

Burden Disclosure: Public reporting burden for this collection of information is
estimated to average 1 minute per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. An agency may
not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. Send comments
regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705
Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA# 0925-0668. Do not
return the completed form to this address.


File Typeapplication/pdf
File TitlePowerPoint Presentation
AuthorGoodman, Geoff
File Modified2020-08-21
File Created2020-06-18

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