Information Collection

NIDDK Health Information Satisfaction Survey

IC 256507 under ICR 202103-0925-003 · 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⚠️ Notice: This information collection may be referencing outdated material.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 NIDDK Health Information survey NIDDK Health Information Satisfaction Survey	Form
1 NIDDK Health Information survey 2022-10-07_NIDDK-Health-Information-Survey_.pdf	Form
Request-for-Approval_OCHIN-NIDDK-EHR-Pilot-Survey.docx fast track for NIDDK Health Information survey	IC Document

IC Title:

NIDDK Health Information Satisfaction Survey

Agency IC Tracking Number:

IC Status: New

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				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 190,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	190,000	190,000
Annual IC Time Burden (Hours)	9,500	9,500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
fast track for NIDDK Health Information survey		10/18/2022

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

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