OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Radiation Dose Tool Feedback

IC 216345 under ICR 201305-0923-003 · OMB 0923-0047.

Documents and Forms
Document Name
Document Type
Other-Telephone Screener
Other-Interview Guide
Other-Telephone Screener
Other-Interview Guide
IC Document
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Radiation Dose Tool Feedback 15AFB
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Telephone Screener ATT C RDT Public Screener.docx Yes Yes Fillable Printable
Other-Interview Guide ATT F RDT Interview Guide for Public.docx No   Paper Only
Other-Telephone Screener ATT D RDT PIO and Public Planners Screener.docx Yes Yes Fillable Printable
Other-Interview Guide ATT G RDT Interview Guide for Public Health.docx No   Paper Only

Health Consumer Health and Safety

 

108 0
   
State, Local, and Tribal Governments
 
   50 %

  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 108 0 108 0 0 0
Annual IC Time Burden (Hours) 48 0 48 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Radiation Dose Tool Appendix H Radiation Dose Tool.pptx 04/29/2015
RDT Protocol Summary ATT A RDT Protocol Summary.docx 04/29/2015
RDT Protocol ATT B RDT Protocol.docx 04/29/2015
Participant Info Sheet ATT E Participant Info Sheet.docx 04/29/2015
Request for Approval Request for Service Delivery GenIC 0923-0047 Radiation Dose Tool.pdf 04/29/2015
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.