Information Collection

Attachment E - Leaders Pre-/Post-Training Quiz

IC 213577 under ICR 201410-0935-002 · OMB 0935-0228.

Documents and Forms

Document Name Document Type
Form 2b Attachment E - Leaders Pre-/Post-Training Quiz Form and Instruction
2b ATTACHMENT E – Hospital Leader Pre-Post Training Quiz Attachment E - Hospital Leader Pre-Post Training Quiz REVISED.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Attachment E - Leaders Pre-/Post-Training Quiz	Agency IC Tracking Number:

Is this a Common Form? No		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	2b	ATTACHMENT E â Hospital Leader Pre-Post Training Quiz	Attachment E - Hospital Leader Pre-Post Training Quiz REVISED.docx		Yes	No	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 26	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	52	52
Annual IC Time Burden (Hours)	17	17
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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