Information Collection

NCATS Genetic and Rare Diseases (GARD) Information Center - Patient Organization Request Form

IC 265004 under ICR 202307-0925-004 · OMB 0925-0766.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0766 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Request Form NCATS Genetic and Rare Diseases (GARD) Information Center - Patient Organization Request Form	Form
1 Request Form GARD 2.0_PO_Request_Form_Desktop.pdf	Form
NCATS GARD Patient Organization Request Form - 0925-0766 Template exp. 9.26.docx Template	IC Document
Contact Us - Genetic and Rare Diseases Information Center.pdf Contact Us Page	IC Document

IC Title:

NCATS Genetic and Rare Diseases (GARD) Information Center - Patient Organization Request Form

Agency IC Tracking Number:

IC Status: New

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				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: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	3	3
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Template		02/07/2024
Contact Us Page		02/07/2024

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

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