Partnerships in Environmental Public Health Training Webpages (NIEHS)

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NIH)

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form 1 Partnerships in Environmental Public Health Training Webpages (NIEHS) Form
1 PEPH Metrics Training Video survey Attachment I PEPH Metrics Training Video Usability Survey Screenshots.docx Form
Recruitment Message.docx email invite IC Document
2021 PEPH Training Video Survey template.docx fast track for PEPH survey IC Document

Information Collection (IC) Details

IC Title:	Partnerships in Environmental Public Health Training Webpages (NIEHS)	Agency IC Tracking Number:

IC Status: Unchanged

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	1	PEPH Metrics Training Video survey	Attachment I PEPH Metrics Training Video Usability Survey Screenshots.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	8	8
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
email invite	Recruitment Message.docx	10/14/2021
fast track for PEPH survey	2021 PEPH Training Video Survey template.docx	10/14/2021

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