Information Collection

NLM SIS Disaster Information Specialization Survey

IC 234683 under ICR 201906-0925-001 · OMB 0925-0648.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 NLM SIS Disaster Information Specialization Survey	Form and Instruction
1 DIS Survey Instrument NLM DIS_Survey Instrument.pdf	Form and Instruction
NLM Fast Track_DIS Survey (1).doc SIS Disaster Information Specialization Survey	IC Document

IC Title:

NLM SIS Disaster Information Specialization Survey

Agency IC Tracking Number:

IC Status: Unchanged

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	DIS Survey Instrument	NLM DIS_Survey Instrument.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 134

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 85 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	134	134
Annual IC Time Burden (Hours)	34	34
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SIS Disaster Information Specialization Survey	NLM Fast Track_DIS Survey (1).doc	01/08/2019

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