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Web-based Ebola Treatment Unit (ETU) Training Course Evaluation
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NCIRD)
OMB: 0920-1026
IC ID: 214384
OMB.report
HHS/CDC
OMB 0920-1026
ICR 201407-0920-001
IC 214384
( )
Documents and Forms
Document Name
Document Type
Web-based Ebola Treatment Unit (ETU) Training Course Evaluation
Form and Instruction
Ebola Treatment Unit (ETU) Training Course Evaluation: D
Attachment B Screen shot Day 1 printout.pdf
Form and Instruction
Ebola Treatment Unit (ETU) Training Course Evaluation: D
Attachment C Screen shot Day 2 printout.pdf
Form and Instruction
Ebola Treatment Unit (ETU) Training Course Evaluation: D
Attachment D Screen shot Day 3 printout.pdf
Form and Instruction
Attachment A CDC ETU Training_notification_slides.pptx
CDC Ebola Training Unit Notification
IC Document
Attachment E Day 1_CDC Ebola Treatment Unit (ETU) Training Course Evaluation.docx
CDC Ebola Treatment Unit Course Evaluation: Day 1
IC Document
Attachment F Day 2_CDC Ebola Treatment Unit (ETU) Training Course Evaluation.docx
CDC Ebola Treatment Unit Course Evaluation: Day 2
IC Document
Attachment E Day 1_CDC Ebola Treatment Unit (ETU) Training Course Evaluation.docx
CDC Ebola Treatment Unit Course Evaluation: Day 1
IC Document
Attachment E Day 1_CDC Ebola Treatment Unit (ETU) Training Course Evaluation.docx
CDC Ebola Treatment Unit Course Evaluation: Day 1
IC Document
Attachment G Day 3_CDC Ebola Treatment Unit (ETU) Training Course Evaluation.docx
CDC Ebola Treatment Unit Course Evaluation: Day 3
IC Document
Attachment G Day 3_CDC Ebola Treatment Unit (ETU) Training Course Evaluation.docx
CDC Ebola Treatment Unit Course Evaluation: Day 3
IC Document
GenIC 0920-1026_Web-based Ebola Treatment Unit (ETU) Training Course Evaluation_REV 22DEC2014.docx
Request for GenIC Approval
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Web-based Ebola Treatment Unit (ETU) Training Course Evaluation
Agency IC Tracking Number:
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
Ebola Treatment Unit (ETU) Training Course Evaluation: Day 2
Attachment C Screen shot Day 2 printout.pdf
None
Yes
Yes
Fillable Fileable
Form and Instruction
None
Ebola Treatment Unit (ETU) Training Course Evaluation: Day 1
Attachment B Screen shot Day 1 printout.pdf
None
Yes
Yes
Fillable Fileable
Form and Instruction
None
Ebola Treatment Unit (ETU) Training Course Evaluation: Day 3
Attachment D Screen shot Day 3 printout.pdf
None
Yes
Yes
Fillable Fileable
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:
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
1,200
0
1,200
0
0
0
Annual IC Time Burden (Hours)
201
0
201
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
CDC Ebola Training Unit Notification
Attachment A CDC ETU Training_notification_slides.pptx
12/22/2014
CDC Ebola Treatment Unit Course Evaluation: Day 1
Attachment E Day 1_CDC Ebola Treatment Unit (ETU) Training Course Evaluation.docx
12/22/2014
CDC Ebola Treatment Unit Course Evaluation: Day 2
Attachment F Day 2_CDC Ebola Treatment Unit (ETU) Training Course Evaluation.docx
12/22/2014
CDC Ebola Treatment Unit Course Evaluation: Day 1
Attachment E Day 1_CDC Ebola Treatment Unit (ETU) Training Course Evaluation.docx
12/22/2014
CDC Ebola Treatment Unit Course Evaluation: Day 1
Attachment E Day 1_CDC Ebola Treatment Unit (ETU) Training Course Evaluation.docx
12/22/2014
CDC Ebola Treatment Unit Course Evaluation: Day 3
Attachment G Day 3_CDC Ebola Treatment Unit (ETU) Training Course Evaluation.docx
12/22/2014
CDC Ebola Treatment Unit Course Evaluation: Day 3
Attachment G Day 3_CDC Ebola Treatment Unit (ETU) Training Course Evaluation.docx
12/22/2014
Request for GenIC Approval
GenIC 0920-1026_Web-based Ebola Treatment Unit (ETU) Training Course Evaluation_REV 22DEC2014.docx
12/22/2014
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.