OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

NASA Enterprise Salesforce COVID-19 Contact Tracing

IC 242541 under ICR 202103-2700-001 · OMB 2700-0178.

Documents and Forms
Document Name
Document Type
Other-Data Collection
Other-Data Collection
Other-Data Collection
Other-Data Collection
Information Collection (IC) Details

View Information Collection (IC)

NASA Enterprise Salesforce COVID-19 Contact Tracing
 
Yes Modified
 
Voluntary
 
42 CFR 2 14 CFR 1212.605

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Data Collection Guided Script - Positive Outreach_v2.3 (1).docx https://nasahealth--nasahltuat.my.salesforce.com No   Paper Only
Other-Data Collection Guided Script - Contact Tracing_v2.3 (1).docx https://nasahealth--nasahltuat.my.salesforce.com Yes Yes Fillable Fileable

General Science and Innovation Scientific and Technological Research and Innovation

NASA 10 HIMS, Health Information Management System  85 FR 79224

5,400 0
   
Individuals or Households
 
   100 %

  Requested 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 5,400 0 0 0 5,400 0
Annual IC Time Burden (Hours) 2,700 0 0 0 2,700 0
Annual IC Cost Burden (Dollars) 118,800 0 118,800 0 0 0

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