OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Emergency Care First-Responders, Physicians, Other Health Care Providers

IC 191875 under ICR 201005-0925-005 · OMB 0925-0612.

Documents and Forms
Document Name
Document Type
Other-Screen Shot
Other-screen shot
Other-Screen Shot
Other-screen shot
Other-screen shot
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Emergency Care First-Responders, Physicians, Other Health Care Providers
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Screen Shot iPhone Splash Screen Shot.pdf Yes Yes Paper Only
Other-screen shot iPhone App About Screen.pdf Yes Yes Paper Only
Other-Screen Shot iPhone User Notice Screen Shot.pdf Yes Yes Paper Only
Other-screen shot iPhone Screen for Data Entry for Emergency Worker.pdf Yes Yes Paper Only
Other-screen shot iPhone Screen Shot with collected info for Reunification Website.pdf Yes Yes Paper Only

Disaster Management Emergency Response

 

500 0
   
Individuals or Households
 
   0 %

  Approved 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 50,000 0 0 0 0 50,000
Annual IC Time Burden (Hours) 4,000 0 0 0 0 4,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
iPhone Screen Shot Burden Statement iPhone Screen Shot Burden Statement.pdf 05/05/2010
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.