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Direct Reading Methodologies, Sensors, and Robotics Technology Assessment in LabSimulator-based Setting

IC 273728 under ICR 202506-0920-001 · OMB 0920-1441.

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Direct Reading Methodologies, Sensors, and Robotics Technology Assessment in LabSimulator-based Setting
 
Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0920-25CW Participant Recruitment Attachment A_Participant Recruitment.docx Yes Yes Fillable Fileable
Form 0920-1441 Informed Consent Form_12JUN2025 Attachment B_Informed Consent_Upd.docx N/A Yes Yes Fillable Fileable
Form 0920-1441 Demographic Survey_12JUN2025 Attachment C_Demographic Survey.docx N/A Yes Yes Fillable Fileable
Form 0920-25CW Robot Experience Questionnaire Attachment D_Robot Experience Questionnaire.docx Yes Yes Fillable Fileable
Form 0920-25CW Comfort Level Questionnaire Attachment E_Comfort Level Questionnaire.docx Yes Yes Fillable Fileable
Form 0920-25CW Post-Interaction Questionnaire Attachment F_Post-Interaction Questionnaire.docx Yes Yes Fillable Fileable
Form 0920-25CW Robot Attribute Ratings Attachment G_Robot Attribute Ratings.docx Yes Yes Fillable Fileable
Form 0920-25CW Record of Test Subject Participation Attachment H_Record of Test Subject Participation.docx Yes Yes Fillable Fileable
Form 0920-25CW Safety and Trust Robots Attachment I - Record of IRB Approval_Safety and Trust Robots.JPG Yes Yes Fillable Fileable

Health Public Health Monitoring

 

801 0
   
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  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 801 0 0 0 0 801
Annual IC Time Burden (Hours) 119 0 0 0 0 119
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
GenIC Request NIOSH DSR genIC_Request to Debit Hours - 24-NIOSH-12 - Mobile Robots.docx 01/16/2025
Change Request Memo_02JUN2025 Change Request form EO 14168.docx 06/02/2025
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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