Screening and Recruiting Call

Workplace Health in America

Documents and Forms

Document Name Document Type
Screening and Recruiting Call Form and Instruction
Screening and Recruiting Call Attachment C-3_ WHA Screening and Recruiting Call_1-29-16.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Screening and Recruiting Call	Agency IC Tracking Number:

Is this a Common Form? No		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
Form and Instruction	none	Screening and Recruiting Call	Attachment C-3_ WHA Screening and Recruiting Call_1-29-16.docx		No		Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 11,684	Number of Respondents for Small Entity: 10,516

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	11,684	11,684
Annual IC Time Burden (Hours)	2,921	2,921
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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