Information Collection

Testing GovDelivery

IC 214226 under ICR 201402-0920-015 · OMB 0920-0956.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Testing GovDelivery Form
Survey
Att.D-Web Survey Questions.docx
Form
Mental Health among Women screenshots - A
Att.C1-Screen Shots-Mental Health among Women of Reproductive Age vA.docx
Form
Mental Health among Women - screenshots - B
Att.C2-Screen Shots-Mental Health among Women of Reproductive Age vB.docx
Form
Environmental Health Training - screenshots - A
Att.C3-Screen Shots-Environmental Health Training in Emergency Response- EHTER.docx
Form
Environmental Health - Screenshots - B
Att.C4-Screen Shots-Environmental Health Training.docx
Form
Integrated Pest Management - screenshots - A
Att.C5-Screen Shots-What Is Integrated Pest Management.docx
Form
Integrated Pest Management - screenshots - B
Att.C6-Screen Shots-Integrated Pest Management.docx
Form
Emergency Supplies - screenshots - A
Att.C7-Screen Shots-Gather Emergency Supplies.docx
Form
Emergency Supplies - screenshots - B
Att.C8-Screen Shots-Emergency Supply Kit.docx
Form
Congenital Heart Defects - screenshots - A
Att.C9-Screen Shots-Five Things You Need to Know about Congenital Heart Defects.docx
Form
Congenital Heart Defects - screenshots - B
Att.C10-Screen Shots-Congenital Heart Defects.docx
Form
Flu shots - screenshots - A
Att.C11-Screen Shots-Pregnant Women Need a Flu Shot.docx
Form
Flu shots - screenshots - B
Att.C12-Screen Shots-Flu Shots and Pregnant Women.docx
Form
Flu vaccine - screenshots - A
Att.C13-Screen Shots-No More Excuses You Need a Flu Vaccine.docx
Form
Flu vaccine - screenshots - B
Att.C14-Screen Shots-Get the Facts to Fight the Flu.docx
Form
Att.A-Web Survey Protocol.docx
Web Survey Protocol
IC Document
GenIC_GovDelivery Index Web Survey.docx
Request for Approval
IC Document
Att.E-Recruitment Materials.docx
Recruitment Materials
IC Document
Att.B1-MentalHealthAmongWomenofReproductiveAge_vA.pdf
Mental Health materials - A
IC Document
Att.B2-MentalHealthAmongWomenofReproductiveAge_vB.pdf
Mental health materials - B
IC Document
Att.B3-EnvironmentalHealthTraininginEmergencyResponseEHTER.pdf
Environmental Health materials - A
IC Document
Att.B4-EnvironmentalHealthTraining.pdf
Environmental Health materials - B
IC Document
Att.B5-WhatisIntegratedPestManagement.pdf
Pest Management materials - A
IC Document
Att.B6-IntegratedPestManagement.pdf
Pest Management materials - B
IC Document
Att.B7-GatherEmergencySupplies.pdf
Emergency Supplies materials - A
IC Document
Att.B8-EmergencySupplyKit.pdf
Emergency Supplies materials - B
IC Document
Att.B9-FiveThingsYouNeedtoKnowAboutCongenitalHeartDefects.pdf
Congential Heart Defects materials - A
IC Document
Att.B10-CongenitalHeartDefects.pdf
Congenital Heart Defects materials - B
IC Document
Att.B11-PregnantWomenNeedaFluShot.pdf
Flu Shots materials - A
IC Document
Att.B12-FluShotsandPregnantWomen.pdf
Flu Shots materials - B
IC Document
Att.B13-NoMoreExcusesYouNeedaFluShot.pdf
Flu Vaccine materials - A
IC Document
Att.B14-GettheFactstoFighttheFlu.pdf
Flu Vaccine materials - B
IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

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 none Survey Att.D-Web Survey Questions.docx Yes Yes Fillable Fileable
Form none Flu vaccine - screenshots - A Att.C13-Screen Shots-No More Excuses You Need a Flu Vaccine.docx Yes Yes Fillable Fileable
Form none Flu vaccine - screenshots - B Att.C14-Screen Shots-Get the Facts to Fight the Flu.docx Yes Yes Fillable Fileable
Form none Mental Health among Women screenshots - A Att.C1-Screen Shots-Mental Health among Women of Reproductive Age vA.docx Yes Yes Fillable Fileable
Form none Mental Health among Women - screenshots - B Att.C2-Screen Shots-Mental Health among Women of Reproductive Age vB.docx Yes Yes Fillable Fileable
Form none Environmental Health Training - screenshots - A Att.C3-Screen Shots-Environmental Health Training in Emergency Response- EHTER.docx Yes Yes Fillable Fileable
Form none Environmental Health - Screenshots - B Att.C4-Screen Shots-Environmental Health Training.docx Yes Yes Fillable Fileable
Form none Integrated Pest Management - screenshots - A Att.C5-Screen Shots-What Is Integrated Pest Management.docx Yes Yes Fillable Fileable
Form none Integrated Pest Management - screenshots - B Att.C6-Screen Shots-Integrated Pest Management.docx Yes Yes Fillable Fileable
Form none Emergency Supplies - screenshots - A Att.C7-Screen Shots-Gather Emergency Supplies.docx Yes Yes Fillable Fileable
Form none Emergency Supplies - screenshots - B Att.C8-Screen Shots-Emergency Supply Kit.docx Yes Yes Fillable Fileable
Form none Congenital Heart Defects - screenshots - A Att.C9-Screen Shots-Five Things You Need to Know about Congenital Heart Defects.docx Yes Yes Fillable Fileable
Form none Congenital Heart Defects - screenshots - B Att.C10-Screen Shots-Congenital Heart Defects.docx Yes Yes Fillable Fileable
Form none Flu shots - screenshots - A Att.C11-Screen Shots-Pregnant Women Need a Flu Shot.docx Yes Yes Fillable Fileable
Form none Flu shots - screenshots - B Att.C12-Screen Shots-Flu Shots and Pregnant Women.docx Yes Yes Fillable Fileable

Federal Enterprise Architecture Business Reference Module


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 700 0 700 0 0 0
Annual IC Time Burden (Hours) 117 0 117 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
Web Survey Protocol Att.A-Web Survey Protocol.docx 12/11/2014
Request for Approval GenIC_GovDelivery Index Web Survey.docx 12/11/2014
Recruitment Materials Att.E-Recruitment Materials.docx 12/11/2014
Mental Health materials - A Att.B1-MentalHealthAmongWomenofReproductiveAge_vA.pdf 12/11/2014
Mental health materials - B Att.B2-MentalHealthAmongWomenofReproductiveAge_vB.pdf 12/11/2014
Environmental Health materials - A Att.B3-EnvironmentalHealthTraininginEmergencyResponseEHTER.pdf 12/11/2014
Environmental Health materials - B Att.B4-EnvironmentalHealthTraining.pdf 12/11/2014
Pest Management materials - A Att.B5-WhatisIntegratedPestManagement.pdf 12/11/2014
Pest Management materials - B Att.B6-IntegratedPestManagement.pdf 12/11/2014
Emergency Supplies materials - A Att.B7-GatherEmergencySupplies.pdf 12/11/2014
Emergency Supplies materials - B Att.B8-EmergencySupplyKit.pdf 12/11/2014
Congential Heart Defects materials - A Att.B9-FiveThingsYouNeedtoKnowAboutCongenitalHeartDefects.pdf 12/11/2014
Congenital Heart Defects materials - B Att.B10-CongenitalHeartDefects.pdf 12/11/2014
Flu Shots materials - A Att.B11-PregnantWomenNeedaFluShot.pdf 12/11/2014
Flu Shots materials - B Att.B12-FluShotsandPregnantWomen.pdf 12/11/2014
Flu Vaccine materials - A Att.B13-NoMoreExcusesYouNeedaFluShot.pdf 12/11/2014
Flu Vaccine materials - B Att.B14-GettheFactstoFighttheFlu.pdf 12/11/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.