Information Collection

Participant Experience Survey_Cancer Diagnostic Process Cohort

IC 258920 under ICR 202303-0935-001 · OMB 0935-0265.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0935-0265 can be found here:

Documents and Forms

Document Name Document Type
Form 6 Participant Experience Survey_Cancer Diagnostic Process Cohort Form and Instruction
6 Attachment F: Participant Experience Survey_Cancer Diagn Att F_Participant Experience Survey_CancerDiagnosticProcess Cohort 1.26.2023.docx Form and Instruction
6 Attachment F: Participant Experience Survey_Cancer Diagn Att F_Participant Experience Survey_CancerDiagnosticProcess Cohort 1.26.2023.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Participant Experience Survey_Cancer Diagnostic Process Cohort	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	6	Attachment F: Participant Experience Survey_Cancer Diagnostic Process Cohort	Att F_Participant Experience Survey_CancerDiagnosticProcess Cohort 1.26.2023.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 75	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	75	75
Annual IC Time Burden (Hours)	13	13
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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