Information Collection Request

Evaluation of the Implementation of TeamSTEPPS in Primary Care Settings (ITS-PC)

ICR 201707-0935-002 · OMB 0935-0222 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1 TeamSTEPPS in Primary Care Post-Training Survey Form Modified Available
Attachments F.docx Supplementary Document Uploaded 2014-08-19 Available
Attachments E.docx Supplementary Document Uploaded 2014-08-19 Available
Attachments D.docx Supplementary Document Uploaded 2014-08-19 Available
TS Primary Care Settings_OMB_Attachment B_Email Notifications_041217.docx Supplementary Document Uploaded 2017-07-19 Available
TS_Primary Care Settings_OMB_Supporting Statement Part B_041217.docx Supporting Statement B Uploaded 2017-07-20 Available
TS_Primary Care Settings_OMB_Supporting Statement Part A_ 04Clean.doc Supporting Statement A Uploaded 2017-07-27 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
212713 TeamSTEPPS in Primary Care Post-Training Survey Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
10/31/2019 24 Months From Approved 10/31/2017
600 0 150
200 0 50
0 0 0





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1
table that charts list of burden
IC Title Form No. Form Name
TeamSTEPPS in Primary Care Post-Training Survey 1 TeamSTEPPS in Primary Care Post-Training Survey

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 600 150 0 450 0 0
Annual Time Burden (Hours) 200 50 0 150 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


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  No