Dispensing Throughput Drill

Form Approved

OMB Approval No. 0920-xxxx

Expiration Date: xx/xx/xxxx

Dispensing Throughput Drill

Drill information

a. Extent of advanced notification (full, partial, none)

b. Number of facilities set up

c. Name of facility (per facility)

d. Type of facility (POD, DVC)

e. Total number of people or vehicles processed through facility (enter per facility)

f. Open or closed facility

g. Walk or Drive through (for PODs)

h. Traditional/Assisted or Express Dispensing

i. Delivery method (Oral, vaccine, other)

j. Target time for set up (in minutes)

Public reporting burden of this collection of information is estimated to average 12 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-xxxx).