Partnership Meeting Questionnaire

The Hospital Preparedness Program

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0391 can be found here:

Documents and Forms

Document Name Document Type
0990-0391 Survey Questions for Partnership Meeting 11-10 (3).docx Other-questionnaire
0990-0391OMB Clearance_Partner Questionnaire_11_9_15 (5).doc Partnership Meeting Questionnaire IC Document

Information Collection (IC) Details

IC Title:	Partnership Meeting Questionnaire	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-questionnaire			0990-0391 Survey Questions for Partnership Meeting 11-10 (3).docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 120	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	120	120
Annual IC Time Burden (Hours)	30	30
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Partnership Meeting Questionnaire	0990-0391OMB Clearance_Partner Questionnaire_11_9_15 (5).doc	11/18/2015

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