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Simulator Sickness Susceptibility Questionnaire
Improving Safety of Human-Robot Interaction
OMB: 0920-1342
IC ID: 245028
OMB.report
HHS/CDC
OMB 0920-1342
ICR 202012-0920-016
IC 245028
( )
Documents and Forms
Document Name
Document Type
Form 0920-20PR
Simulator Sickness Susceptibility Questionnaire
Form and Instruction
0920-20PR Simulator Sickness Questionnaire
Attachment D - Instrument A - Simulator Sickness Questionnaire.docx
Form and Instruction
0920-20PR Simulator Sickness Questionnaire
Attachment D - Instrument A - Simulator Sickness Questionnaire.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Simulator Sickness Susceptibility Questionnaire
Agency IC Tracking Number:
0920-20PR
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
0920-20PR
Simulator Sickness Questionnaire
Attachment D - Instrument A - Simulator Sickness Questionnaire.docx
No
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Worker Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
37
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
37
0
37
0
0
0
Annual IC Time Burden (Hours)
1
0
1
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
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.