Radiation Exposure Screening and Education Program Measures

Radiation Exposure Screening and Education Program Performance Improvement and Measurement System (PIMS)

⚠️ Notice: This information collection may be referencing outdated material.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
0906-0012 RESEP OMB Number and Expiration.jpg 0906-0012 RESEP OMB Number and Expiration IC Document
0906-0012 RESEP Burden Statement.jpg 0906-0012 RESEP Burden Statement IC Document

Information Collection (IC) Details

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	Previously Approved
Annual Number of Responses for this IC	8	8
Annual IC Time Burden (Hours)	96	96
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
0906-0012 RESEP OMB Number and Expiration	0906-0012 RESEP OMB Number and Expiration.jpg	10/24/2018
0906-0012 RESEP Burden Statement	0906-0012 RESEP Burden Statement.jpg	10/24/2018

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.