Self-Reported Shoulder/Arm (Upper Extremity) Pain Questionnaire - Original Data Collection

Musculoskeletal Disorder (MSD) Intervention Effectiveness in an Insurer-Supported Engineering Control Program

OMB: 0920-0907

IC ID: 198865

Information Collection (IC) Details

View Information Collection (IC)

Self-Reported Shoulder/Arm (Upper Extremity) Pain Questionnaire - Original Data Collection
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction None Self-Reported Shoulder/Arm Pain Questionnaire Attachment H-2 Self Report Shoulder Arm.docx None Yes Yes Fillable Fileable

Workforce Management Worker Safety

 

87 0
   
Private Sector Businesses or other for-profits
 
   95 %

  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 305 0 -4,015 0 0 4,320
Annual IC Time Burden (Hours) 25 0 -335 0 0 360
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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