HPV Cancer Center Consortium Survey (NCI)

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⚠️ Notice: This information collection may be referencing outdated material.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 HPV Cancer Center Consortium Survey (NCI) Form
1 survey screenshot HPV_Cancer_Center_Consortium_Survey FINAL.docx Form
Sub-study_HPV CCC FINAL.docx fast track for HPV CCC survey IC Document
HPV Post Survey Cover Email_013023_final.docx email IC Document

Information Collection (IC) Details

IC Title:	HPV Cancer Center Consortium Survey (NCI)	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	survey screenshot	HPV_Cancer_Center_Consortium_Survey FINAL.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	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	100	100
Annual IC Time Burden (Hours)	17	17
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
fast track for HPV CCC survey	Sub-study_HPV CCC FINAL.docx	02/16/2023
email	HPV Post Survey Cover Email_013023_final.docx	02/16/2023

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