Information Collection

NIH Workplace Civility and Equity Survey_Screenshots

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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 NIH Workplace Civility and Equity Survey_Screenshots	Form
Form 1 Attachment 2 survey screenshot 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

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

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: 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 %

table that charts list of burden
	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

table that charts IC Documents
Title	Document	Date Uploaded
NIH Workplace CES Survey With Display Logic		09/15/2022

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

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