CE Survey Form

Initial Assessment and Evaluation of Public Health Training Centers Programs

OMB: 0915-0380

IC ID: 210867

Documents and Forms
Information Collection (IC) Details

View Information Collection (IC)

CE Survey Form
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 questionnaire Instrument.docx Yes Yes Fillable Fileable

Health Immunization Management

 

1,569 0
   
Individuals or Households
 
   100 %

  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 1,569 0 1,569 0 0 0
Annual IC Time Burden (Hours) 251 0 251 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Confidentiality Agreement Confidentiality Agreement.docx 03/20/2014
Informed Consent Informed Consent.docx 03/20/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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