Information Collection

Self-Nomination for ME/CFS Research Roadmap Working Group (NINDS)

IC 256978 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⚠️ Notice: This information collection may be referencing outdated material.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 Self-Nomination for ME/CFS Research Roadmap Working Group (NINDS)	Form and Instruction
Form 1 Self-Nomination for ME/CFS Research Roadmap Working Group (NINDS)	Form and Instruction
1 Survey Self-Nomination for ME_CFS Research Roadmap Working Group (Preview).pdf	Form and Instruction
1 Survey Self-Nomination for ME_CFS Research Roadmap Working Group (Preview).pdf	Form and Instruction
MECFS PRA Clearance Form-SubstudyTemplate_110822 (2).docx Template	IC Document
MECFS PRA Clearance Form-SubstudyTemplate_110822 (2).docx Template	IC Document
Open Nomination email ME CFS 110822 (3).docx Recruitment Materials	IC Document
Open Nomination email ME CFS 110822 (3).docx Recruitment Materials	IC Document

IC Title:

Self-Nomination for ME/CFS Research Roadmap Working Group (NINDS)

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 and Instruction	1	Survey	Self-Nomination for ME_CFS Research Roadmap Working Group (Preview).pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

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	100	100
Annual IC Time Burden (Hours)	33	33
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Template	MECFS PRA Clearance Form-SubstudyTemplate_110822 (2).docx	11/17/2022
Recruitment Materials	Open Nomination email ME CFS 110822 (3).docx	11/17/2022

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