Hospital Preparedness Program (HPP) Impact Survey

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⚠️ Notice: This information collection may be referencing outdated material.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
HPP Impact Survey_Draft Questions_9 27 2017_v22.docx Other-survey
Ex_0990-Generic_Memo Template_HPP Impact Survey_10 25 2017 (2).doc memo IC Document

Information Collection (IC) Details

IC Title:	Hospital Preparedness Program (HPP) Impact Survey	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			HPP Impact Survey_Draft Questions_9 27 2017_v22.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 386	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	386	386
Annual IC Time Burden (Hours)	97	97
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
memo	Ex_0990-Generic_Memo Template_HPP Impact Survey_10 25 2017 (2).doc	10/25/2017

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