Information Collection

Surveys to Support Assessment of Research Centers in Minority Institutions (RCMI) Program (NIMHD)

IC 254438 under ICR 202301-0925-002 · OMB 0925-0766.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0766 can be found here:

2023-07-31 - Extension without change of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Surveys to Support Assessment of Research Centers in Minority Institutions (RCMI) Program (NIMHD)	Form
Form 1 Community Advisory Board Member Survey Surveys to Support Assessment of Research Centers in Minority Institutions (RCMI) Program (NIMHD)	Form
Form 2 Faculty Survey Surveys to Support Assessment of Research Centers in Minority Institutions (RCMI) Program (NIMHD)	Form
Form 3 Institutional Leaders Survey Surveys to Support Assessment of Research Centers in Minority Institutions (RCMI) Program (NIMHD)	Form
Form 4 RCMI Leadership Survey Surveys to Support Assessment of Research Centers in Minority Institutions (RCMI) Program (NIMHD)	Form
Form 5 Scientific Advisory Committee Members Survey Surveys to Support Assessment of Research Centers in Minority Institutions (RCMI) Program (NIMHD)	Form
1 Community Advisory Board Member Survey Community Advisory Board Member Survey_CS.pdf	Form
1 Community Advisory Board Member Survey Community Advisory Board Member Survey_CS.pdf	Form
2 Faculty Survey Faculty Survey_CS.pdf	Form
2 Faculty Survey Faculty Survey_CS.pdf	Form
3 Institutional Leaders Survey Institutional Leaders Survey_CS.pdf	Form
3 Institutional Leaders Survey Institutional Leaders Survey_CS.pdf	Form
4 RCMI Leadership Survey RCMI Leadership Survey_CS.pdf	Form
4 RCMI Leadership Survey RCMI Leadership Survey_CS.pdf	Form
5 Scientific Advisory Committee Members Survey Scientific Advisory Committee Members Survey_CS.pdf	Form
5 Scientific Advisory Committee Members Survey Scientific Advisory Committee Members Survey_CS.pdf	Form
NIH Citizen Science and Crowdsourcing Generic Clearance Form - RCMI Surveys_6.9.2022.docx sub-study for Assessment of RCMI Program	IC Document
NIH Citizen Science and Crowdsourcing Generic Clearance Form - RCMI Surveys_6.9.2022.docx sub-study for Assessment of RCMI Program	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Surveys to Support Assessment of Research Centers in Minority Institutions (RCMI) Program (NIMHD)

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	1	Community Advisory Board Member Survey	Community Advisory Board Member Survey_CS.pdf	Yes	Yes	Fillable Fileable
Form	2	Faculty Survey	Faculty Survey_CS.pdf	Yes	Yes	Fillable Fileable
Form	3	Institutional Leaders Survey	Institutional Leaders Survey_CS.pdf	Yes	Yes	Fillable Fileable
Form	4	RCMI Leadership Survey	RCMI Leadership Survey_CS.pdf	Yes	Yes	Fillable Fileable
Form	5	Scientific Advisory Committee Members Survey	Scientific Advisory Committee Members Survey_CS.pdf	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: 977

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	977	977
Annual IC Time Burden (Hours)	306	306
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
sub-study for Assessment of RCMI Program	NIH Citizen Science and Crowdsourcing Generic Clearance Form - RCMI Surveys_6.9.2022.docx	06/29/2022

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