Information Collection

Clinical Electives Program 1 Year Alumni Survey

IC 237577 under ICR 202407-0925-001 · OMB 0925-0602.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Clinical Electives Program 1 Year Alumni Survey	Form
1 Survey Attachment 1_ Clinical Electives Program.pdf	Form
1 Survey Attachment 1_ Clinical Electives Program.pdf	Form

IC Title:

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	Survey	Attachment 1_ Clinical Electives Program.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

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

FR Citation: 67 FR 60741

Number of Respondents: 100

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
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	33	33
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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