Information Collection

PCP Lecture Evaluation (General Public)

IC 237836 under ICR 202603-0925-001 · OMB 0925-0764.

Documents and Forms

Document Name Document Type
Form 1 Evaluation PCP Lecture Evaluation (General Public) Form
1 Evaluation PCP Lecture Evaluation.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	PCP Lecture Evaluation (General Public)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	Evaluation	PCP Lecture 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: 3,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	3,000	2,000	1,000
Annual IC Time Burden (Hours)	150	67	83
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.

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