Information Collection

Pre-Training Survey (Nursing)

IC 220383 under ICR 201707-0920-006 · OMB 0920-1129.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Pre-Training Survey (Nursing)	Form
Nursing Pre-Training Survey G1 Pre Training Survey for Nursing.pdf	Form
UPDATED G1 Pre-Training Survey for Nursing.docx Pre-Training Survey (Nursing)	IC Document

IC Title:

Pre-Training Survey (Nursing)

Agency IC Tracking Number:

17ADN

Is this a Common Form? No

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
Form	none	Nursing Pre-Training Survey	G1 Pre Training 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: 667

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	Previously Approved
Annual Number of Responses for this IC	667	667
Annual IC Time Burden (Hours)	100	100
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Pre-Training Survey (Nursing)	UPDATED G1 Pre-Training Survey for Nursing.docx	05/09/2017

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