Information Collection

HMTS Radiation Focus Group and Emergencies Infographics

IC 208746 under ICR 201111-0920-003 · OMB 0920-0572.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0572 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Att C_RRS Screening Inst 091213.docx	Other-Word
Att C-1 ORIG Screenng Instrmnt Word 20130912.docx	Other-Word
Att E_Moderator Guide 20130912.docx	Other-Word
Att C-2 ORIGScreenngInstrmntScreenshots.pdf	Other-Word
Att E-1 ORIG Survey Questions Word 20130815.docx	Other-WORD
Att E-2ORIGSurveyScreenshots8.19.pdf	Other-WORD
Att A_RRS Protocol Summary 20130912.docx Att A_RRS Protocol Summary 20130912	IC Document
Att B_RRS Protocol 20130912 (2).docx Att B_RRS Protocol 20130912 (2)	IC Document
Att D_RRS Participant Info Sheet 20130912.docx Att D_RRS Participant Info Sheet 20130912	IC Document
Att F_Radiation Risk Scale 20130806.pdf Att F_Radiation Risk Scale 20130806	IC Document
Radiation Risk Scale List of Attchmnts 20130806.docx Radiation Risk Scale List of Attchmnts 20130806	IC Document
Att A ORIG Protocol Summary 20130815.docx Att A ORIG Protocol Summary 20130815	IC Document
Att B ORIG Protocol 20130815.docx Att B ORIG Protocol 20130815	IC Document
Att D ORIG Prtcpnt Info Webpage 20130815.docx Att D ORIG Prtcpnt Info Webpage 20130815	IC Document
ORIG List of Attchmnts 20130815.docx ORIG List of Attchmnts 20130815	IC Document
HMTS Expedited Review Form Rad Risk Scale 20130806.pdf HMTS Expedited Review Form Rad Risk Scale 20130806	IC Document
HMTS Expedited Review Form Online Rad Infographics.pdf HMTS Expedited Review Form Online Rad Infographics	IC Document

IC Title:

HMTS Radiation Focus Group and Emergencies Infographics

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Word	No	No	Fillable Printable
Other-Word	Yes	Yes	Fillable Printable
Other-Word	No	No	Fillable Printable
Other-Word	Yes	Yes	Fillable Printable
Other-WORD	Yes	Yes	Fillable Printable
Other-WORD	Yes	Yes	Fillable Printable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,088

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	2,088	0	0	0	0	0
Annual IC Time Burden (Hours)	372	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
Att A_RRS Protocol Summary 20130912		09/16/2013
Att B_RRS Protocol 20130912 (2)		09/16/2013
Att D_RRS Participant Info Sheet 20130912		09/16/2013
Att F_Radiation Risk Scale 20130806		09/16/2013
Radiation Risk Scale List of Attchmnts 20130806		09/16/2013
Att A ORIG Protocol Summary 20130815		09/16/2013
Att B ORIG Protocol 20130815		09/16/2013
Att D ORIG Prtcpnt Info Webpage 20130815		09/16/2013
ORIG List of Attchmnts 20130815		09/16/2013
HMTS Expedited Review Form Rad Risk Scale 20130806		09/19/2013
HMTS Expedited Review Form Online Rad Infographics		09/19/2013

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

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