Information Collection

Six-Month Follow-Up Training Survey (Nursing)

IC 220385 under ICR 202102-0920-003 · OMB 0920-1129.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Six-Month Follow-Up Training Survey (Nursing)	Form
Nursing Training Follow-up Survey G3 Six Month Follow Up Survey for Nursing.pdf	Form
Nursing Training Follow-up Survey G3 Six Month Follow Up Survey for Nursing.pdf	Form
UPDATED G3 Six Month Follow Up Survey for Nursing.docx Six-Month Follow-up Training Survey (Nursing)- word	IC Document
UPDATED G3 Six Month Follow Up Survey for Nursing.docx Six-Month Follow-up Training Survey (Nursing)- word	IC Document

IC Title:

Agency IC Tracking Number:

17ADN

Is this a Common Form? No

IC Status: Removed

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
Form	none	Nursing Training Follow-up Survey	G3 Six Month Follow Up Survey for Nursing.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 440

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	-440	440
Annual IC Time Burden (Hours)	-66	66
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Six-Month Follow-up Training Survey (Nursing)- word	UPDATED G3 Six Month Follow Up Survey for Nursing.docx	05/09/2017

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