Information Collection

Collecting Feedback from Cancer Fatigue Event Participants (NINR)

IC 249740 under ICR 202307-0925-002 · OMB 0925-0648.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Collecting Feedback from Cancer Fatigue Event Participants (NINR)	Form
1 2021 Cancer Fatigue survey NINR_Survey_2021-10-06.pdf	Form
NINR_SurveyEmail_2021-10-06.pdf email invite	IC Document
NINR_FastTrack_2021-10-06.docx Collecting Feedback from Cancer Fatigue Event Participants (NINR)	IC Document

IC Title:

Collecting Feedback from Cancer Fatigue Event Participants (NINR)

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	2021 Cancer Fatigue survey	NINR_Survey_2021-10-06.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 140

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	140	140
Annual IC Time Burden (Hours)	12	12
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
email invite	NINR_SurveyEmail_2021-10-06.pdf	10/14/2021
Collecting Feedback from Cancer Fatigue Event Participants (NINR)	NINR_FastTrack_2021-10-06.docx	10/14/2021

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