Dr. Sano's Weekly Pulse Survey (CC)

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⚠️ Notice: This information collection may be referencing outdated material.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 Dr. Sano's Weekly Pulse Survey (CC) Form and Instruction
1 Survey Weekly Pulse Survey screen .png Form and Instruction
Email for 2022 Weekly Pulse Survey (1).pdf Recruitment Email IC Document
Template -- Sano Pulse Survey rev4.docx Template IC Document

Information Collection (IC) Details

IC Title:	Dr. Sano's Weekly Pulse Survey (CC)	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 and Instruction	1	Survey	Weekly Pulse Survey screen .png		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 55	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	55	55
Annual IC Time Burden (Hours)	2	2
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Recruitment Email	Email for 2022 Weekly Pulse Survey (1).pdf	11/15/2022
Template	Template -- Sano Pulse Survey rev4.docx	11/15/2022

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