Information Collection

(OC) Assessments of Patient and Patient Advocate Experience with the FDA For Patients Website and FDA Patient Listening Session program

IC 265992 under ICR 202311-0910-013 · OMB 0910-0697.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix 1 For Patients Website Interview Guide FINAL.docx	Other-Interview guide
Appendix 1a Consent for Website Interview Participants FINAL.docx	Other-Consent
Appendix 2 For Patients Website Post Listening Session Survey FINAL.docx	Other-Post-interview survey
OMB Memo For Patients Website FINAL.docx OMB Memo / Abbreviated Supporting Statement	IC Document

IC Title:

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Interview guide	Appendix 1 For Patients Website Interview Guide FINAL.docx	Yes	Yes	Fillable Fileable
Other-Consent	Appendix 1a Consent for Website Interview Participants FINAL.docx	Yes	Yes	Fillable Fileable Signable
Other-Post-interview survey	Appendix 2 For Patients Website Post Listening Session Survey FINAL.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 142

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	142	142
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB Memo / Abbreviated Supporting Statement	OMB Memo For Patients Website FINAL.docx	03/14/2024

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