Information Collection Request

Evaluation of the Implementation of TeamSTEPPS in Primary Care Settings (ITS-PC)

ICR 201408-0935-002 · OMB 0935-0222 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1 TeamSTEPPS in Primary Care Post-Training Survey Form New Available
Attachments F.docx Supplementary Document Uploaded 2014-08-19 Available
Attachments E.docx Supplementary Document Uploaded 2014-08-19 Available
Attachments D.docx Supplementary Document Uploaded 2014-08-19 Repair queued
Attachment C.docx Supplementary Document Uploaded 2014-08-19 Available
TS_Primary_Care_OMB_Supporting Statement Part B_FINAL.docx Supporting Statement B Uploaded 2014-08-19 Available
TS_Primary_Care_Supporting Statement Part A-FINAL(3).doc Supporting Statement A Uploaded 2014-08-19 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
212713 TeamSTEPPS in Primary Care Post-Training Survey Form New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
10/31/2017 36 Months From Approved
150 0 0
50 0 0
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
TeamSTEPPS in Primary Care Post-Training Survey 1 TeamSTEPPS in Primary Care Post-Training Survey

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 150 0 0 150 0 0
Annual Time Burden (Hours) 50 0 0 50 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No