Information Collection

Implementation Science Webinar Survey (NCI)

IC 239676 under ICR 201905-0925-001 · OMB 0925-0642.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0642 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Implementation Science Webinar Survey (NCI)	Form and Instruction
1 Implementation Science Webinar survey Implementation Science Webinar Survey.pdf	Form and Instruction
Fast Track - Implementation Science Webinar v2.docx Fasat track Implementation Science Webinar survey	IC Document

IC Title:

Implementation Science Webinar Survey (NCI)

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Implementation Science Webinar survey	Implementation Science Webinar Survey.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 400

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	400	400
Annual IC Time Burden (Hours)	33	33
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fasat track Implementation Science Webinar survey	Fast Track - Implementation Science Webinar v2.docx	01/30/2020

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