Physician Data Query (PDQ) Partner Survey (NCI)

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

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form 1 Physician Data Query (PDQ) Partner Survey (NCI) Form
1 PDQ Partner survey PDQ Partner Survey July 2020.docx Form
PDQ Partner Survey Email.docx PDQ Partner email invitation IC Document
Generic Fast Track Sub-Study - PDQ Partner Survey July 2020.docx Fast Track sub-study PDQ Partner Survey IC Document

Information Collection (IC) Details

IC Title:	Physician Data Query (PDQ) Partner Survey (NCI)	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	PDQ Partner survey	PDQ Partner Survey July 2020.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 40	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	40	40
Annual IC Time Burden (Hours)	3	3
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
PDQ Partner email invitation	PDQ Partner Survey Email.docx	07/09/2020
Fast Track sub-study PDQ Partner Survey	Generic Fast Track Sub-Study - PDQ Partner Survey July 2020.docx	07/09/2020

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