Information Collection

2026 Department of Laboratory Medicine (DLM) Services Stakeholder Perception Survey

IC 280569 under ICR 202406-0925-001 · OMB 0925-0648.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Survey 2026 Department of Laboratory Medicine (DLM) Services Stakeholder Perception Survey	Form
1 Survey 2026 DLM Stakeholder Satisfaction Survey Questions.docx	Form
0925-0648 application AHMAD4.docx Template	IC Document
2026 Department of Laboratory Medicine Survey solicitation email.docx Email Correspondence	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	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: 622

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	622	622
Annual IC Time Burden (Hours)	21	21
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Template		05/28/2026
Email Correspondence		05/28/2026

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

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