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CDC Ebola Treatment Unit Training Course Evaluation
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NCIRD)
OMB: 0920-1026
IC ID: 213465
OMB.report
HHS/CDC
OMB 0920-1026
ICR 201407-0920-001
IC 213465
( )
Documents and Forms
Document Name
Document Type
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
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
CDC Ebola Treatment Unit Training Course Evaluation
Agency IC Tracking Number:
15BJ
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
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
Federal Enterprise Architecture Business Reference Module
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 %
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
1,200
0
1,200
0
0
0
Annual IC Time Burden (Hours)
166
0
166
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.