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Healthcare and Public Health Sector Site Assessment Risk Analysis' (SARA) Integrated Toolkit Feedback Form
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
OMB: 0990-0379
IC ID: 227449
OMB.report
HHS/HHSDM
OMB 0990-0379
ICR 201503-0990-001
IC 227449
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0379 can be found here:
2024-07-08 - No material or nonsubstantive change to a currently approved collection
2024-02-28 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
0990-0379 HPH Risk Toolkit Pilot II Participant Survey 2017-07-10.docx
Other-survey
0990-0379 FastTrackDraft Generic Clearance Submission_SARA Survey_07July 17.docx
Healthcare and Public Health Sector Site Assessment Risk Analysis’ (SARA) Integrated Toolkit Feedback Form
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Healthcare and Public Health Sector Site Assessment Risk Analysis' (SARA) Integrated Toolkit Feedback Form
Agency IC Tracking Number:
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-survey
0990-0379 HPH Risk Toolkit Pilot II Participant Survey 2017-07-10.docx
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
20
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
20
0
20
0
0
0
Annual IC Time Burden (Hours)
33
0
33
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Healthcare and Public Health Sector Site Assessment Risk Analysis’ (SARA) Integrated Toolkit Feedback Form
0990-0379 FastTrackDraft Generic Clearance Submission_SARA Survey_07July 17.docx
07/11/2017
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.