Information Collection

Examining the Use of Climate Change Health Indicators by Health Departments in Adaptation Planning

IC 220836 under ICR 201704-0990-009 · OMB 0990-0421.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0421 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
0990-0421Attachment A_Climate_Change_II_Webinar_Guide (2).docx	Other-guide
0990-0421SSA_Climate Change and Health_OMB generic.docx Support statement A	IC Document
0990-0421SSB_Climate Change and Health OMB generic.docx Suppt st. B	IC Document
0990-0421OMB Cover Sheet_CC and Health Indicators.doc Memo	IC Document
0990-0421Attachment B_Climate_Change_II_Webinar_Consent_Form.docx consent form	IC Document

IC Title:

Examining the Use of Climate Change Health Indicators by Health Departments in Adaptation Planning

Agency IC Tracking Number:

IC Status: Unchanged

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-guide					No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 25

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	25	25
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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

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