Information Collection

CDC Ebola Treatment Unit Training Course Evaluation

IC 213465 under ICR 201407-0920-001 · OMB 0920-1026.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Day 1 CDC Ebola Treatment Unit (ETU) Training Course Evaluation CDC Ebola Treatment Unit Training Course Evaluation	Form and Instruction
Day 2 CDC Ebola Treatment Unit (ETU) Training Course Evaluation CDC Ebola Treatment Unit Training Course Evaluation	Form and Instruction
Day 3 CDC Ebola Treatment Unit (ETU) Training Course Evaluation CDC Ebola Treatment Unit Training Course Evaluation	Form and Instruction
Day 1 CDC Ebola Treatment Unit (ETU) Training Course Eva Day 1_CDC Ebola Treatment Unit (ETU) Training Course Evaluation rev.docx	Form and Instruction
Day 2 CDC Ebola Treatment Unit (ETU) Training Course Eva Day 2_CDC Ebola Treatment Unit (ETU) Training Course Evaluation rev.docx	Form and Instruction
Day 3 CDC Ebola Treatment Unit (ETU) Training Course Eva Day 3_CDC Ebola Treatment Unit (ETU) Training Course Evaluation rev.docx	Form and Instruction
GenIC 0920-1026_Ebola Treatment Unit (ETU) Training Course Evaluation_final.docx Request for GenIC Approval	IC Document

IC Title:

Agency IC Tracking Number:

15BJ

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Electronic Capability
Form and Instruction	None	Day 1 CDC Ebola Treatment Unit (ETU) Training Course Evaluation	Day 1_CDC Ebola Treatment Unit (ETU) Training Course Evaluation rev.docx	None	No	Paper Only
Form and Instruction	None	Day 2 CDC Ebola Treatment Unit (ETU) Training Course Evaluation	Day 2_CDC Ebola Treatment Unit (ETU) Training Course Evaluation rev.docx	None	No	Paper Only
Form and Instruction	None	Day 3 CDC Ebola Treatment Unit (ETU) Training Course Evaluation	Day 3_CDC Ebola Treatment Unit (ETU) Training Course Evaluation rev.docx	None	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,200

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,200	1,200
Annual IC Time Burden (Hours)	166	166
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Request for GenIC Approval	GenIC 0920-1026_Ebola Treatment Unit (ETU) Training Course Evaluation_final.docx	10/10/2014

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