Information Collection

Occupational injuries and illnesses among emergency medical services (EMS) workers: A NEISS-Work telephone interview survey

IC 191021 under ICR 200910-0920-005 · OMB 0920-0834.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0834 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Occupational injuries and illnesses among emergency medical services (EMS) workers: A NEISS-Work telephone interview survey	Form and Instruction
1 EMS Worker Injury and Illness Questionnaire Appendix D_090910.doc	Form and Instruction

IC Title:

Occupational injuries and illnesses among emergency medical services (EMS) workers: A NEISS-Work telephone interview survey

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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 and Instruction	1	EMS Worker Injury and Illness Questionnaire	Appendix D_090910.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: Epidemiologic Studies and Surveillance of Disease Problems

FR Citation: 57 FR 62812

Number of Respondents: 175

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	175	175
Annual IC Time Burden (Hours)	58	58
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.