Information Collection

Nih Cerebral Visual Impairment (cvi) Registry Clinical Site Interest And Feasibility Form (nei)

IC 275315 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⚠️ Notice: This information collection may be referencing outdated material.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 Form NIH CEREBRAL VISUAL IMPAIRMENT (CVI) REGISTRY CLINICAL SITE INTEREST AND FEASIBILITY FORM (NEI)	Form
1 Form NIH CVI REGISTRY CLINICAL SITE INTEREST_AND FEASIBILITY FORM.pdf	Form
Sub-Study - Web Form CVI Registry.docx Template	IC Document
NEI correspondence.docx Correspondence	IC Document

IC Title:

NIH CEREBRAL VISUAL IMPAIRMENT (CVI) REGISTRY CLINICAL SITE INTEREST AND FEASIBILITY FORM (NEI)

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: Records of Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public Health Service

FR Citation: 67 FR 60742

Number of Respondents: 15

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	15	15
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		05/15/2025
Correspondence		05/15/2025

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

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