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Attachment B: Workshop Post-Training Survey
Evaluation of the Educating the Educator (EtE) Workshop
OMB: 0935-0220
IC ID: 212058
OMB.report
HHS/AHRQ
OMB 0935-0220
ICR 201406-0935-001
IC 212058
( )
Documents and Forms
Document Name
Document Type
Form 2
Attachment B: Workshop Post-Training Survey
Form and Instruction
2 Attachment B: Workshop Post-Training Survey
ATTACHMENT B_Survey2-Post-Training 6-24-14.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Attachment B: Workshop Post-Training Survey
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
2
Attachment B: Workshop Post-Training Survey
ATTACHMENT B_Survey2-Post-Training 6-24-14.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1,500
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
1,500
0
1,500
0
0
0
Annual IC Time Burden (Hours)
375
0
375
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.