Information Collection

DHDSP Newletters: Assessing Usage, Usefulness and Access

IC 198401 under ICR 201008-0920-003 · OMB 0920-0864.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
DHDSP Newletters: Assessing Usage, Usefulness and Access	Form
DHDSP Newsletters Survey IC_4_Att 1a_Survey 06 29 2011.docx	Form
IC_4_Att 1b_Survey Screenshots 06 29 2011.pdf Survey Screenshots	IC Document
IC_4_Att 2_Introductory Email 06 29 2011.docx Introductory Email	IC Document
IC_4_Att 3_Invitational Email 06 29 2011.docx Invitational Email	IC Document
IC_4_Att 4_Followup Email 06 29 2011.docx Follow-up Email	IC Document
IC_4_Supporting Statement 06 29 2011.docx Supporting Statements A and B	IC Document

IC Title:

Agency IC Tracking Number:

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	none	DHDSP Newsletters Survey	IC_4_Att 1a_Survey 06 29 2011.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 473

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	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	473	0	0	0	0	0
Annual IC Time Burden (Hours)	79	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Survey Screenshots	IC_4_Att 1b_Survey Screenshots 06 29 2011.pdf	06/30/2011
Introductory Email	IC_4_Att 2_Introductory Email 06 29 2011.docx	06/30/2011
Invitational Email	IC_4_Att 3_Invitational Email 06 29 2011.docx	06/30/2011
Follow-up Email	IC_4_Att 4_Followup Email 06 29 2011.docx	06/30/2011
Supporting Statements A and B	IC_4_Supporting Statement 06 29 2011.docx	06/30/2011

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