Covid-19 Post Learning Community Survey

COVID-19 POST LEARNING COMMUNITY SURVEY

Documents and Forms

Document Name Document Type
POST SURVEY ONLY COVID-19 Survey Instrument PRA.pdf Other-Survey
POST SURVEY ONLY COVID-19 Survey Instrument PRA.pdf Other-Survey

Information Collection (IC) Details

IC Title:	COVID-19 POST LEARNING COMMUNITY SURVEY	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
Other-Survey			POST SURVEY ONLY COVID-19 Survey Instrument PRA.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: 09-90-1901 HHS Correspondence, Customer Service, and Contact List Records	FR Citation: 86 FR 11306

Number of Respondents: 200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	17	17
Annual IC Cost Burden (Dollars)	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.