Information Collection

National Institute of Neurological Disorders and Stroke (NINDS) Health Disparities in Tribal Communities (HDTC) Pre- and Post-Program Surveys

IC 268033 under ICR 202308-0925-001 · OMB 0925-0778.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0778 can be found here:

2026-09-28 - Revision of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Pre Survey National Institute of Neurological Disorders and Stroke (NINDS) Health Disparities in Tribal Communities (HDTC) Pre- and Post-Program Surveys	Form
Form 2 Post Survey National Institute of Neurological Disorders and Stroke (NINDS) Health Disparities in Tribal Communities (HDTC) Pre- and Post-Program Surveys	Form
1 Pre Survey MicrosoftFormsScreenshot_Pre.pdf	Form
2 Post Survey MicrosoftFormsScreenshot_Post.pdf	Form
Sub-Study - HDTC Pre and Post CustParticipationSatisfaction.docx Template	IC Document
HDTC Pre_Post Emails.docx Email Correspondence	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

National Institute of Neurological Disorders and Stroke (NINDS) Health Disparities in Tribal Communities (HDTC) Pre- and Post-Program Surveys

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
Form	2				Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: Clinical Research: Student Records FR Citation 67 FR 60742; 09-25-0156 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: 30

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	30	30
Annual IC Time Burden (Hours)	5	5
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Template		05/29/2024
Email Correspondence		05/29/2024

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

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