Information Collection

Training Staff Training Needs Assessment, Evaluation/Survey - Question Compilation

IC 199736 under ICR 201110-0938-006 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-10374 Training Staff Training Needs Assessment, Evaluation/Survey - Question Compilation	Form and Instruction
CMS-10374 Training Staff Training Needs Assessment, Evaluation/Sur 508 PRA_QuestionsCompliation vers4.pdf	Form and Instruction

IC Title:

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	CMS-10374	Training Staff Training Needs Assessment, Evaluation/Survey - Question Compilation	508 PRA_QuestionsCompliation vers4.pdf		No	No	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,161

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to New Statute
Annual Number of Responses for this IC	4,322	4,322
Annual IC Time Burden (Hours)	1,426	1,426
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.