Information Collection

Preparing Healthcare Workers to Work in Ebola Treatment Units (ETUs) in Africa: Training Toolkit_Registration and Evaluation

IC 214582 under ICR 201407-0920-001 · OMB 0920-1026.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Preparing Healthcare Workers to Work in Ebola Treatment Units (ETUs) in Africa: Training Toolkit_Registration and Evaluation	Form
Registration Attachment A_Preparing HCW to Work in ETUs in Africa Training Toolkit_Registration Questionnaire.pdf	Form
Evaluation Attachment B_Preparing HCW to Work in ETUs in Africa Training Toolkit_Evaluation Survey.pdf	Form
Attachment C_Reminder Email_Incomplete Registration.docx Reminder Email for Incomplete Registration	IC Document
Attachment D_Registration Complete_Thank You Email.docx Registration Complete Email	IC Document
Attachment E_Toolkit Availability Email Notification.docx Toolkit Availability Email Notification	IC Document
Attachment F_Invitation Email for Evaluation Survey.docx Evaluation Email Invitation	IC Document
Attachment G_Reminder Email_Incomplete Evaluation Survey.docx Reminder Email Imcomplete Evaluation	IC Document
GenIC 0920-1026_CDC Ebola ETU Toolkit_Registration and Evaluation Surveys_Final.docx Request for Approval	IC Document

IC Title:

Agency IC Tracking Number:

15IX

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?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Registration	Attachment A_Preparing HCW to Work in ETUs in Africa Training Toolkit_Registration Questionnaire.pdf		Yes	Yes	Fillable Fileable
Form	none	Evaluation	Attachment B_Preparing HCW to Work in ETUs in Africa Training Toolkit_Evaluation Survey.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,300

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,300	1,300
Annual IC Time Burden (Hours)	370	370
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Reminder Email for Incomplete Registration	Attachment C_Reminder Email_Incomplete Registration.docx	01/12/2015
Registration Complete Email	Attachment D_Registration Complete_Thank You Email.docx	01/12/2015
Toolkit Availability Email Notification	Attachment E_Toolkit Availability Email Notification.docx	01/12/2015
Evaluation Email Invitation	Attachment F_Invitation Email for Evaluation Survey.docx	01/12/2015
Reminder Email Imcomplete Evaluation	Attachment G_Reminder Email_Incomplete Evaluation Survey.docx	01/12/2015
Request for Approval	GenIC 0920-1026_CDC Ebola ETU Toolkit_Registration and Evaluation Surveys_Final.docx	01/12/2015

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