Information Collection

Safety Communication Campaign (DOHS/OD)

IC 239642 under ICR 201906-0925-001 · OMB 0925-0648.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
01292020-CLagoe-Burden-Safety Communication Campaign Survey-Interviews.pdf	Instruction
01292020-CLagoe-Request-Safety Communication Campaign.docx Fast Track Request for Safety Communication Campaign	IC Document
01292020-CLagoe-Recruitment Email?Sent from OSHC Members.docx Recuritment email Sent from OSHC members	IC Document
01292020-CLagoe-Recruitment Email?To Be Sent From Safety Specialists.docx Recruitment Email to be sent from Safety Specialist	IC Document

IC Title:

Safety Communication Campaign (DOHS/OD)

Agency IC Tracking Number:

IC Status: New

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
Instruction			01292020-CLagoe-Burden-Safety Communication Campaign Survey-Interviews.pdf		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast Track Request for Safety Communication Campaign	01292020-CLagoe-Request-Safety Communication Campaign.docx	01/29/2020
Recuritment email Sent from OSHC members	01292020-CLagoe-Recruitment Email?Sent from OSHC Members.docx	01/29/2020
Recruitment Email to be sent from Safety Specialist	01292020-CLagoe-Recruitment Email?To Be Sent From Safety Specialists.docx	01/29/2020

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