WTCHP Responders and Survivors (private citizens)

The World Trade Center Health Program: Impact Assessment and Strategic Planning for Translational Research (Part 1, Formative Research: Focus Groups)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1252 can be found here:

Documents and Forms

Document Name Document Type
WTCHP Responders and Survivors (private citizens) Form and Instruction
Focus Group Discussion Guide Att D_FG protocol_2018-11-14_clean.docx Form and Instruction
Brief Demographic Survey Att G_Brief Demo Survey_2018-11-14.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	WTCHP Responders and Survivors (private citizens)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

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	n/a	Focus Group Discussion Guide	Att D_FG protocol_2018-11-14_clean.docx		No		Paper Only
Form and Instruction	n/a	Brief Demographic Survey	Att G_Brief Demo Survey_2018-11-14.pdf		No		Fillable Fileable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 15	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	15	15
Annual IC Time Burden (Hours)	30	30
Annual IC Cost Burden (Dollars)	922	922

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.