Information Collection

iCURE Scholar Questionnaire (NCI)

IC 255543 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⚠️ Notice: This information collection may be referencing outdated material.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 iCURE Scholar Questionnaire (NCI)	Form
Form 1 iCURE Scholar Questionnaire (NCI)	Form
1 iCURE 2022 questionnaire screenshot iCURE 2022 Scholar Questionnaire Screenshots.pdf	Form
1 iCURE 2022 questionnaire screenshot iCURE 2022 Scholar Questionnaire Screenshots.pdf	Form
Sub-Study Template_iCURE FINAL.docx sub-study for iCURE 2022 Questionnaire	IC Document
Sub-Study Template_iCURE FINAL.docx sub-study for iCURE 2022 Questionnaire	IC Document
iCURE 2022 Scholar Invitation_DRAFT.docx email invitation	IC Document
iCURE 2022 Scholar Invitation_DRAFT.docx email invitation	IC Document

IC Title:

iCURE Scholar Questionnaire (NCI)

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	iCURE 2022 questionnaire screenshot	iCURE 2022 Scholar Questionnaire Screenshots.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 22

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	22	22
Annual IC Time Burden (Hours)	4	4
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
sub-study for iCURE 2022 Questionnaire	Sub-Study Template_iCURE FINAL.docx	08/24/2022
email invitation	iCURE 2022 Scholar Invitation_DRAFT.docx	08/24/2022

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