Information Collection

Virtual Human Service Delivery under COVID-19: Scan of Implementation and Lessons Learned

IC 242167 under ICR 201705-0990-002 · 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⚠️ Notice: This information collection may be referencing outdated material.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
Form 0 Virtual Human Service Delivery under COVID-19: Scan of Implementation and Lessons Learned	Form
0 Demographic Questionnaire Attachment C - Demographic Questionnaire 6-1-20.docx	Form
Cover sheet for OMB Generic Clearance-Virtual Human Services_6-1-20 (1).docx memo	IC Document
Attachment B - Semi-Structured Discussion Guides and Consent Scripts 6-1-20 (1).docx Consent and guidance	IC Document
Attachment A - Recruitment Email 6-1-20.docx Recruitment email	IC Document
SupportingStatement B - ASPE Generic_Virtual_Human_Services_Delivery 6-1-20 (2).docx SS-B	IC Document
SS-A Generic_Virtual_Human_Services_Delivery 6_4_20.docx SS-A	IC Document

IC Title:

Virtual Human Service Delivery under COVID-19: Scan of Implementation and Lessons Learned

Agency IC Tracking Number:

IC Status: New

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
Form	0	Demographic Questionnaire	Attachment C - Demographic Questionnaire 6-1-20.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 114

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	114	114
Annual IC Time Burden (Hours)	135	135
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
memo	Cover sheet for OMB Generic Clearance-Virtual Human Services_6-1-20 (1).docx	06/04/2020
Consent and guidance	Attachment B - Semi-Structured Discussion Guides and Consent Scripts 6-1-20 (1).docx	06/04/2020
Recruitment email	Attachment A - Recruitment Email 6-1-20.docx	06/04/2020
SS-B	SupportingStatement B - ASPE Generic_Virtual_Human_Services_Delivery 6-1-20 (2).docx	06/04/2020
SS-A	SS-A Generic_Virtual_Human_Services_Delivery 6_4_20.docx	06/04/2020

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