Information Collection

Survey to Assess Hepatitis B Vaccination Coverage Among U.S. Health-Care Workers

IC 7016 under ICR 200207-0920-004 · OMB 0920-0563.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

Survey to Assess Hepatitis B Vaccination Coverage Among U.S. Health-Care Workers

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

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

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 425

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	11,050	11,050
Annual IC Time Burden (Hours)	2,869	2,869
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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Title	Document	Date Uploaded

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