Information Collection

Safety Communication Campaign (DOHS/OD)

IC 239642 under ICR 202104-0925-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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-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-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–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
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: Unchanged

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					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
	Requested	Previously Approved
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		01/29/2020
Recuritment email Sent from OSHC members		01/29/2020
Recruitment Email to be sent from Safety Specialist		01/29/2020

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

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