Information Collection

Stigma trainee survey (FIC)

IC 255314 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⚠️ Notice: This information collection may be referencing outdated material.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:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Stigma trainee survey (FIC)	Form
Form 1 Stigma trainee survey (FIC)	Form
1 Stigma survey screenshot Survey Screenshots (2).docx	Form
1 Stigma survey screenshot Survey Screenshots (2).docx	Form
sub-study for Crowdsourcing Stigma.docx sub-study for Stigma Trainee survey	IC Document
sub-study for Crowdsourcing Stigma.docx sub-study for Stigma Trainee survey	IC Document
Outreach Email (3).docx outreach email	IC Document
Outreach Email (3).docx outreach email	IC Document

IC Title:

Stigma trainee survey (FIC)

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	Stigma survey screenshot	Survey Screenshots (2).docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 51

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	51	51
Annual IC Time Burden (Hours)	13	13
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
sub-study for Stigma Trainee survey	sub-study for Crowdsourcing Stigma.docx	08/15/2022
outreach email	Outreach Email (3).docx	08/15/2022

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