Yellowstone National Park Backcountry Survey [Paper Version]

Survey of Illness and Injury Among Backcountry Users in Yellowstone National Park

Documents and Forms

Document Name Document Type
Yellowstone National Park Backcountry Survey [Paper Version] Form and Instruction
Yellowstone National Park Backcountry Survey Appendix P_Yellowstone Study Questionnaire - Paper Version_060707.doc Form and Instruction
Appendix N_Yellowstone Study Introductory Letter_060607.doc Introductory Letter IC Document
Appendix O_Yellowstone Study Consent - Paper Version_060607.doc Yellowstone Study Consent IC Document

Information Collection (IC) Details

IC Title:	Yellowstone National Park Backcountry Survey [Paper Version]	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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 and Instruction	None	Yellowstone National Park Backcountry Survey	Appendix P_Yellowstone Study Questionnaire - Paper Version_060707.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title: 0920-0136, Epidemiologic Studies and Surveillance of Disease Problems	FR Citation: 57 FR 62812

Number of Respondents: 109	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	109	109
Annual IC Time Burden (Hours)	91	91
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Introductory Letter	Appendix N_Yellowstone Study Introductory Letter_060607.doc	06/13/2007
Yellowstone Study Consent	Appendix O_Yellowstone Study Consent - Paper Version_060607.doc	06/13/2007

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