OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Flu on CallTM National Network of Telephone Triage Lines Demonstration Pilot

IC 219405 under ICR 201407-0920-001 · OMB 0920-1026.

Documents and Forms
Document Name
Document Type
Instruction
Instruction
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Flu on CallTM National Network of Telephone Triage Lines Demonstration Pilot 16HQ
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction Attachment A_United Way 211 Information Specialist Intake Screen_Flu OnCall.jpg NA Yes Yes Fillable Fileable
Instruction Attachment B_Management Guidelines for Adults (≥18 years) or Children (2-17 years) with Possible Influenza-Like Illness.docx NA Yes Yes Fillable Fileable

Health Illness Prevention

 

4,500 0
   
Individuals or Households
 
   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 4,500 0 4,500 0 0 0
Annual IC Time Burden (Hours) 195 0 195 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
GenIC Request 0920-1026_GenIC_Demonstration Pilot_ Flu On Call TM_National Network of Telephone Triage Lines _Final ICRO 12 23 2015.docx 12/23/2015
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.