Information Collection

OBGYN Telecom Training Survey

IC 220400 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⚠️ Notice: This information collection may be referencing outdated material.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
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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.