Core Competencies for Amputation Rehabilitation Surveys

Core Competencies for Amputee Rehabilitation

Documents and Forms

Document Name Document Type
Invitation Letter for Civilian Rehab Providers.docx Other-Invitation Email for Civilian
Invitation Letter for DoDcontractors.docx Other-Invitation Email for DoD Contr
Informed Consent_Civilian Rehab Provider Interviews 08.07.2017.docx Other-Informed Consent_Civilian Reha
Informed Consent_DoD Contractor Provider Interviews.docx Other-Informed Consent_DoD Contracto
EACE Letter of Support for RAND Interviews.pdf Other-Recruitment Letter/Letter of S
EACE Interview protocol for DoD contractor providers 29July16.docx Other-Interview Questions - DoD cont
EACE Interview Protocol for Civilian Rehabilitation Providers 08.07.2017.docx Other-Interview Questions - Civilian

Information Collection (IC) Details

IC Title:	Core Competencies for Amputation Rehabilitation Surveys	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Invitation Email for DoD Contractors	Invitation Letter for DoDcontractors.docx	Yes	Yes	Fillable Fileable
Other-Invitation Email for Civilian Rehab Providers	Invitation Letter for Civilian Rehab Providers.docx	Yes	Yes	Fillable Fileable
Other-Recruitment Letter/Letter of Support	EACE Letter of Support for RAND Interviews.pdf	No		Paper Only
Other-Interview Questions - DoD contractor providers	EACE Interview protocol for DoD contractor providers 29July16.docx	No		Paper Only
Other-Interview Questions - Civilian Rehab Providers	EACE Interview Protocol for Civilian Rehabilitation Providers 08.07.2017.docx	No		Paper Only
Other-Informed Consent_Civilian Rehab Provider	Informed Consent_Civilian Rehab Provider Interviews 08.07.2017.docx	No		Paper Only
Other-Informed Consent_DoD Contractor Provider	Informed Consent_DoD Contractor Provider Interviews.docx	No		Paper Only

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 400	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	400	400
Annual IC Time Burden (Hours)	400	400
Annual IC Cost Burden (Dollars)	47,600	47,600

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.