Baseline Survey

Monitoring and Coordinating Personal Protective Equipment (PPE) in Healthcare to Enhance Domestic Preparedness for Ebola Response

OMB: 0920-1131

IC ID: 221842

Documents and Forms
Information Collection (IC) Details

View Information Collection (IC)

Baseline Survey
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction NA Web-Based Survey - Baseline Att E Web Base Survey Updated Survey and Crisis Text Message.pdf NA Yes Yes Fillable Fileable

Workforce Management Worker Safety

 

7 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   95 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 7 0 7 0 0 0
Annual IC Time Burden (Hours) 56 0 56 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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