Information Collection

Basic Electronic Survey to Inform Development of a Nursing Research Brochure

IC 230717 under ICR 202102-0925-005 · 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⚠️ Notice: This information collection may be referencing outdated material.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 Basic Electronic Survey to Inform Development of a Nursing Research Brochure	Form and Instruction
1 Survey Screenshots Appendix A_NINR Survey Screenshots_updated.pdf	Form and Instruction
1 Survey Screenshots Appendix A_NINR Survey Screenshots_updated.pdf	Form and Instruction
1 Survey Instrument Appendix A_NINR Survey Instrument_updated.docx	Form and Instruction
1 Survey Instrument Appendix A_NINR Survey Instrument_updated.docx	Form and Instruction
Fast Track_NINR Brochure_3_13_18.doc Fast Track NINR Brochure	IC Document
Fast Track_NINR Brochure_3_13_18.doc Fast Track NINR Brochure	IC Document
Appendix B_Survey Invitation Email Screenshot_updated.pdf Survey invitation email	IC Document
Appendix B_Survey Invitation Email Screenshot_updated.pdf Survey invitation email	IC Document

IC Title:

Basic Electronic Survey to Inform Development of a Nursing Research Brochure

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	Survey Screenshots	Appendix A_NINR Survey Screenshots_updated.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	1	Survey Instrument	Appendix A_NINR Survey Instrument_updated.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast Track NINR Brochure	Fast Track_NINR Brochure_3_13_18.doc	03/15/2018
Survey invitation email	Appendix B_Survey Invitation Email Screenshot_updated.pdf	03/22/2018

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