Information Collection

Hospital Preparedness Program (HPP) Impact Survey

IC 228505 under ICR 201504-0990-001 · OMB 0990-0391.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

IC Title:

Hospital Preparedness Program (HPP) Impact Survey

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.