Information Collection

Sickle Cell Psychoeducation Support Group: Interest Survey (NHLBI)

IC 256775 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⚠️ Notice: This information collection may be referencing outdated material.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 Sickle Cell Psychoeducation Support Group: Interest Survey (NHLBI)	Form
1 sickle cell interest survey sickle cell interest survey.docx	Form
Fast Track Template for Sickle cell interest survey (1).docx fast track study for Sickle Cell Interest survey	IC Document

IC Title:

Sickle Cell Psychoeducation Support Group: Interest Survey (NHLBI)

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	sickle cell interest survey	sickle cell interest survey.docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 20

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	20	20
Annual IC Time Burden (Hours)	2	2
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
fast track study for Sickle Cell Interest survey	Fast Track Template for Sickle cell interest survey (1).docx	11/08/2022

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