Information Collection

Department of Laboratory Medicine Operational Review: 2020 Stakeholder Perception Survey of Services (CC)

IC 240091 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⚠️ Notice: This information collection may be referencing outdated material.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 Department of Laboratory Medicine Operational Review: 2020 Stakeholder Perception Survey of Services (CC)	Form
Form 1 DLM Stakeholder Perception Survey Department of Laboratory Medicine Operational Review: 2020 Stakeholder Perception Survey of Services (CC)	Form
1 DLM Stakeholder Perception Survey DLM Stakeholder Perception Survey_ OMB Request_FINAL.pdf	Form
1 DLM Stakeholder Perception Survey DLM Stakeholder Perception Survey_ OMB Request_FINAL.pdf	Form
Request for OMB Approval- DLM Fast Track 2020.docx Fast track DLM	IC Document
Request for OMB Approval- DLM Fast Track 2020.docx Fast track DLM	IC Document

IC Title:

Department of Laboratory Medicine Operational Review: 2020 Stakeholder Perception Survey of Services (CC)

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	1	DLM Stakeholder Perception Survey	DLM Stakeholder Perception Survey_ OMB Request_FINAL.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,500

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	3,500	3,500
Annual IC Time Burden (Hours)	117	117
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast track DLM	Request for OMB Approval- DLM Fast Track 2020.docx	02/24/2020

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