Information Collection

Radiation Exposure Screening and Education Program Measures

IC 217672 under ICR 201804-0906-003 · OMB 0906-0012.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0906-0012 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Radiation Exposure Screening and Education Program Measures Form and Instruction
1 PIMS Measures PIMS Measures_RESEP Final DRAFT.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Radiation Exposure Screening and Education Program Measures	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

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	1	PIMS Measures	PIMS Measures_RESEP Final DRAFT.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 8	Number of Respondents for Small Entity: 4

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	8	-34	42
Annual IC Time Burden (Hours)	96	-912	1,008
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.