Information Collection

NIH Workplace Civility and Equity Survey_Screenshots

IC 254659 under ICR 202207-0925-001 · OMB 0925-0776.

Documents and Forms

Document Name Document Type
Form 1 NIH Workplace Civility and Equity Survey_Screenshots Form
1 Attachment 2 survey screenshot NIH Workplace Civility and Equity Survey_Screenshots 6-15-2022.pdf Form
1 Attachment 2 survey screenshot Attachment 2 NIH Workplace Civility and Equity Survey_Screenshots 9-14-2022.pdf Form
Attachment 1 NIH Workplace CES Survey With Display Logic.pdf NIH Workplace CES Survey With Display Logic IC Document
Attachment 1 NIH Workplace CES amended final (logic).pdf NIH Workplace CES Survey With Display Logic IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	NIH Workplace Civility and Equity Survey_Screenshots	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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	Attachment 2 survey screenshot	Attachment 2 NIH Workplace Civility and Equity Survey_Screenshots 9-14-2022.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: 09-25-0156, Records of Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public Health Service	FR Citation: 67 FR 60742

Number of Respondents: 31,517	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	31,517	31,517
Annual IC Time Burden (Hours)	7,879	7,879
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
NIH Workplace CES Survey With Display Logic	Attachment 1 NIH Workplace CES amended final (logic).pdf	09/15/2022

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