Information Collection

Participant Feedback for the Mary Frances Picciano Dietary Supplement Research Practicum (DSRP) on May 29–31, 2019 at the Lister Hill Auditorium (NLM)

IC 235845 under ICR 202104-0925-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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 Participant Feedback for the Mary Frances Picciano Dietary Supplement Research Practicum (DSRP) on May 29–31, 2019 at the Lister Hill Auditorium (NLM)	Form and Instruction
1 Evaluation Day 1 screenshot Evaluation Day 1_Screenshot 4-24-19.docx	Form and Instruction
1 Evaluation Day 1 screenshot Evaluation Day 1_Screenshot 4-24-19.docx	Form and Instruction
2 Evaluation Day 2 screenshot Evaluation Day 2_Screenshot 4-24-19 (1).docx	Form and Instruction
2 Evaluation Day 2 screenshot Evaluation Day 2_Screenshot 4-24-19 (1).docx	Form and Instruction
3 Evaluation Day 3 screenshot Evaluation Day 3_Screenshot 4-24-19 (1).docx	Form and Instruction
3 Evaluation Day 3 screenshot Evaluation Day 3_Screenshot 4-24-19 (1).docx	Form and Instruction
0925-0648_Practicum_Feedback_Survey_Clearance.doc Practicum Feedback Survey fast track	IC Document
0925-0648_Practicum_Feedback_Survey_Clearance.doc Practicum Feedback Survey fast track	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Participant Feedback for the Mary Frances Picciano Dietary Supplement Research Practicum (DSRP) on May 29â31, 2019 at the Lister Hill Auditorium (NLM)

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Evaluation Day 1 screenshot	Evaluation Day 1_Screenshot 4-24-19.docx	Yes	Yes	Fillable Fileable
Form and Instruction	2	Evaluation Day 2 screenshot	Evaluation Day 2_Screenshot 4-24-19 (1).docx	Yes	Yes	Fillable Fileable
Form and Instruction	3	Evaluation Day 3 screenshot	Evaluation Day 3_Screenshot 4-24-19 (1).docx	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 125

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	375	375
Annual IC Time Burden (Hours)	219	219
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Practicum Feedback Survey fast track	0925-0648_Practicum_Feedback_Survey_Clearance.doc	04/26/2019

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