Information Collection

IPPCR Final Course Evaluation (Healthcare Professionals)

IC 237763 under ICR 202402-0925-002 · OMB 0925-0764.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0764 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 IPPCR Final Course Evaluation (Healthcare Professionals)	Form
1 Evaluation IPPCR Final Course Evaluation.docx	Form
1 Evaluation IPPCR Final Course Evaluation.docx	Form
IPPCR Final Course Evaluation (3).doc IPPCR Final Course Evaluation Word Doc	IC Document
IPPCR Final Course Evaluation (3).doc IPPCR Final Course Evaluation Word Doc	IC Document

IC Title:

IPPCR Final Course Evaluation (Healthcare Professionals)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	Evaluation	IPPCR Final Course Evaluation.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: 09-25-0014 entitled Clinical Research: Student Records, HHS/NIH/OD/OIR/OE

FR Citation: 67 FR 60742

Number of Respondents: 1,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,000	0	1,000
Annual IC Time Burden (Hours)	83	-84	167
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
IPPCR Final Course Evaluation Word Doc	IPPCR Final Course Evaluation (3).doc	09/16/2019

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