Information Collection

Re-entry Messaging Following a Radiation Emergency

IC 226565 under ICR 201502-0920-001 · OMB 0920-0572.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0572 can be found here:

Documents and Forms

Document Name Document Type
Att A Screenr Reentry Mssgs.docx Other-WORD
Att C Reentry Mod guide.docx Other-WORD
Att B Reentry mssgs.docx Att B_Radiation Reentry Message IC Document
Att D Partpnt Info Sheet Fcs Grps.docx Att D_Participant Information Sheet IC Document
Att E Reentry Messages_ Protocol.docx Att E_Protocol Detail IC Document
Att F Sample Reentry Scenario.docx Att F_Scenario IC Document
Reentry messages project summary.docx Re-Entry Message Summary IC Document
NCEH-ATSDR Research Determination Form-OSSigned.pdf NCEH/ATSDR HSR Determination IC Document
ORAU approval letter_Reentry Messages.pdf ORAU IRB IC Document
HMTSExpeditedReviewForm-Msg Rentry.pdf HMTS Expedited Review Form IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Re-entry Messaging Following a Radiation Emergency	Agency IC Tracking Number:	17AHA

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
Other-WORD			Att C Reentry Mod guide.docx		No		Paper Only
Other-WORD			Att A Screenr Reentry Mssgs.docx		No		Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 24	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	48	48
Annual IC Time Burden (Hours)	44	44
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Att B_Radiation Reentry Message	Att B Reentry mssgs.docx	04/26/2017
Att D_Participant Information Sheet	Att D Partpnt Info Sheet Fcs Grps.docx	04/26/2017
Att E_Protocol Detail	Att E Reentry Messages_ Protocol.docx	04/26/2017
Att F_Scenario	Att F Sample Reentry Scenario.docx	04/26/2017
Re-Entry Message Summary	Reentry messages project summary.docx	04/26/2017
NCEH/ATSDR HSR Determination	NCEH-ATSDR Research Determination Form-OSSigned.pdf	04/26/2017
ORAU IRB	ORAU approval letter_Reentry Messages.pdf	04/26/2017
HMTS Expedited Review Form	HMTSExpeditedReviewForm-Msg Rentry.pdf	04/26/2017

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