Employer Follow-Up Survey

National Healthy Worksite Program

OMB: 0920-0965

IC ID: 202679

Documents and Forms
Document Name
Document Type
Other-WORD
Information Collection (IC) Details

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Employer Follow-Up Survey
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-WORD Att E-7_Er FU Surv.pdf No No Paper Only

Health Immunization Management

 

33 10
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Requested 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 33 0 33 0 0 0
Annual IC Time Burden (Hours) 8 0 8 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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