Information Collection

OHR Proof of Concept Assessment Surveys (OD)

IC 253287 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⚠️ Notice: This information collection may be referencing outdated material.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 OHR Proof of Concept Assessment Surveys (OD)	Form
1 Employees-Managers Pulse Check OHR Proof of Concept Assessment_Employees-Managers Pulse Check- Screen shots (002).docx	Form
2 Customer Survey OHR Proof of Concept- Customer Survey- Screen shots.docx	Form
3 Open Feedback OHR Proof of Concept Assessment_Employees-Managers Open Feedback- Screen shots.docx	Form
Fast Track Template- NIH OHR.docx fast track for OHR Proof of Concept	IC Document

IC Title:

OHR Proof of Concept Assessment Surveys (OD)

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	Employees-Managers Pulse Check	OHR Proof of Concept Assessment_Employees-Managers Pulse Check- Screen shots (002).docx	Yes	Yes	Fillable Fileable
Form	2	Customer Survey	OHR Proof of Concept- Customer Survey- Screen shots.docx	Yes	Yes	Fillable Fileable
Form	3	Open Feedback	OHR Proof of Concept Assessment_Employees-Managers Open Feedback- Screen shots.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 566

Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	6,324	6,324
Annual IC Time Burden (Hours)	527	527
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
fast track for OHR Proof of Concept	Fast Track Template- NIH OHR.docx	05/06/2022

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