.ICARE Dialogues Customer feedback pre- and post-session surveys (OLAW/OD)

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⚠️ Notice: This information collection may be referencing outdated material.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 .ICARE Dialogues Customer feedback pre- and post-session surveys (OLAW/OD) Form
1 Survey Part 1 Pre-session Supporting document Survey part 1_pre-session survey_.pdf Form
1 Survey Part 1 Pre-session Supporting document Survey part 1_pre-session survey_.pdf Form
2 Survey Part 2 Post-session Supporting document Survey part 2_post-session survey.pdf Form
2 Survey Part 2 Post-session Supporting document Survey part 2_post-session survey.pdf Form
ICARE Dialogues OMB Approval App Customer feedback Surveys Sessions 12 through 19.docx Fast track ICARE Dialogues feedback sessions 12 through 19 IC Document
ICARE Dialogues OMB Approval App Customer feedback Surveys Sessions 12 through 19.docx Fast track ICARE Dialogues feedback sessions 12 through 19 IC Document

Information Collection (IC) Details

IC Title:	.ICARE Dialogues Customer feedback pre- and post-session surveys (OLAW/OD)	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	Survey Part 1 Pre-session	Supporting document Survey part 1_pre-session survey_.pdf		Yes	Yes	Fillable Fileable
Form	2	Survey Part 2 Post-session	Supporting document Survey part 2_post-session survey.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 ICARE Dialogues feedback sessions 12 through 19	ICARE Dialogues OMB Approval App Customer feedback Surveys Sessions 12 through 19.docx	02/02/2021

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