Nursing Follow-up Training Survey

Improving Fetal Alcohol Spectrum Disorders Prevention and Practice through Practice and Implementation Centers and National Partnerships

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1129 can be found here:

Documents and Forms

Document Name Document Type
Nursing Follow-up Training Survey Form
Nursing Training Follow-up Survey Q3 Six Month Follow-Up Survey for Nursing.pdf Form
G3 Six Month Follow Up Survey for Nursing.docx Nursing Training Followup Survey - word IC Document

Information Collection (IC) Details

IC Title:	Nursing Follow-up Training Survey	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	none	Nursing Training Follow-up Survey	Q3 Six Month Follow-Up Survey for Nursing.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 440	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	440	440
Annual IC Time Burden (Hours)	66	66
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Nursing Training Followup Survey - word	G3 Six Month Follow Up Survey for Nursing.docx	03/02/2016

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