Information Collection

BRIM Investigator Post-Meeting Survey (NCCIH)

IC 253967 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⚠️ Notice: This information collection may be referencing outdated material.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

Document Name Document Type
Form 1 BRIM Investigator Post-Meeting Survey (NCCIH) Form
1 BRIM Post Meeting survey NCCIH BRIM Post Meeting Survey.docx Form
2022 Fast Track Template-BRIM customer feedback survey.docx BRIM Investigator Post-Meeting Survey (NCCIH) IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	BRIM Investigator Post-Meeting Survey (NCCIH)	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	BRIM Post Meeting survey	NCCIH BRIM Post Meeting Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 19	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	19	19
Annual IC Time Burden (Hours)	3	3
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
BRIM Investigator Post-Meeting Survey (NCCIH)	2022 Fast Track Template-BRIM customer feedback survey.docx	06/01/2022

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