Information Collection

TeamSTEPPS 2.0 Online Post-Training Survey

IC 213196 under ICR 201708-0935-003 · OMB 0935-0224.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 TeamSTEPPS 2.0 Online Post-Training Survey	Form and Instruction
1 Attachment A Post Training Survey TS_Online_OMB_Attachment A_Post_Training_Survey_040617.docx	Form and Instruction

IC Title:

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	1	Attachment A Post Training Survey	TS_Online_OMB_Attachment A_Post_Training_Survey_040617.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	3,000	3,000
Annual IC Time Burden (Hours)	1,000	1,000
Annual IC Cost Burden (Dollars)	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.