[ATSDR] Heat and Health Tracker Evaluation Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

OMB: 0923-0047

IC ID: 259022

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Document Name
Document Type
Form and Instruction
Other-WORD
Form and Instruction
IC Document
IC Document
IC Document
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[ATSDR] Heat and Health Tracker Evaluation Survey 0923-0047-23DN
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920 Page 1 Heat and Health Tracker Evaluation Survey AttB_HHT Evaluation Survey (REDCap).pdf Yes Yes Fillable Fileable
Other-WORD AttB_HHT Evaluation Survey (Word).docx No   Paper Only

Workforce Management Training and Employment

 

71 0
   
State, Local, and Tribal Governments
 
   100 %

  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 71 0 71 0 0 0
Annual IC Time Burden (Hours) 18 0 18 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Email Invitation to HHT Evaluation Survey AttA_Email Invitation HHT Evaluation Survey.docx 03/09/2023
HHT STARS Determination AttC_STARS Determination.pdf 03/09/2023
Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” GenIC Rqst 0923-0047 HHT Evaluation Survey.docx 03/09/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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