OBGYN Telecom Training Survey

Improving Fetal Alcohol Spectrum Disorders Prevention and Practice through Practice and Implementation Centers and National Partnerships

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form 0920-1129 OBGYN Telecom Training Survey Form and Instruction
OBGYN Telecom Training Satisfaction Survey_Screenshot_REVIEWED.PDF Other-WORD
0920-1129 OBGYN Telecom Training Satisfaction Survey (TTS) OBGYN Telecom Training Satisfaction Survey_Screenshot_REVIEWED.PDF Form and Instruction

Information Collection (IC) Details

IC Title:	OBGYN Telecom Training Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-1129	OBGYN Telecom Training Satisfaction Survey (TTS)	OBGYN Telecom Training Satisfaction Survey_Screenshot_REVIEWED.PDF		Yes	Yes	Fillable Fileable
Other-WORD			OBGYN Telecom Training Satisfaction Survey_Screenshot_REVIEWED.PDF		No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 480	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	480	0	480
Annual IC Time Burden (Hours)	24	-16	40
Annual IC Cost Burden (Dollars)	0	0	0

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.