Interview Protocol for Public Health Preparedness Coalition Leader

Healthcare System Surge Capacity at the Community Level

Documents and Forms

Document Name Document Type
Interview Protocol for Public Health Preparedness Coalition Leader Form
Protocol for PH Preparedness clean_Attachment D--Interview Protocol 2--Public Health and Preparedness Coalition Leader 3-4.doc Form

Information Collection (IC) Details

IC Title:	Interview Protocol for Public Health Preparedness Coalition Leader	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	none	Protocol for PH Preparedness	clean_Attachment D--Interview Protocol 2--Public Health and Preparedness Coalition Leader 3-4.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	20	20
Annual IC Time Burden (Hours)	20	20
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.