Information Collection

COVID-19 Clinical Data Coordination Seminar Year End Questionnaire (NLM)

IC 257509 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⚠️ Notice: This information collection may be referencing outdated material.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 COVID-19 Clinical Data Coordination Seminar Year End Questionnaire (NLM)	Form
1 COVID Year-end survey Year-End Survey Instrument.pdf	Form
Approved Fast Track Template 10_2022 .docx fast track for COVID Year end survey	IC Document
Email Samples.docx email invite	IC Document

IC Title:

COVID-19 Clinical Data Coordination Seminar Year End Questionnaire (NLM)

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	COVID Year-end survey	Year-End Survey Instrument.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 150

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	150	150
Annual IC Time Burden (Hours)	13	13
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
fast track for COVID Year end survey	Approved Fast Track Template 10_2022 .docx	12/21/2022
email invite	Email Samples.docx	12/21/2022

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