CRIS Vaccine Survey (NCI)

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

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form 1 CRIS Vaccine Survey (NCI) Form
1 CRIS Survey CRIS Survey Screen Shot.pdf Form
1 CRIS Survey CRIS Survey Screen Shot.pdf Form
Fast Track Request Vaccine Survey -0925-0648 3.6.20 v2 (2).docx Fast Track Vaccine Survey IC Document
Fast Track Request Vaccine Survey -0925-0648 3.6.20 v2 (2).docx Fast Track Vaccine Survey IC Document
Email to Prescribers about CRIS 3.6.2020.docx email to prescribers about CRIS IC Document
Email to Prescribers about CRIS 3.6.2020.docx email to prescribers about CRIS IC Document

Information Collection (IC) Details

IC Title:	CRIS Vaccine Survey (NCI)	Agency IC Tracking Number:

IC Status: Unchanged

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	CRIS Survey	CRIS Survey Screen Shot.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
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

Title	Document	Date Uploaded
Fast Track Vaccine Survey	Fast Track Request Vaccine Survey -0925-0648 3.6.20 v2 (2).docx	03/10/2020
email to prescribers about CRIS	Email to Prescribers about CRIS 3.6.2020.docx	03/10/2020

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