Information Collection

Nist Hurricane Maria Study, Hurricane Maria Recovery Of Critical Social Functions Project: Hospital Recovery Following Hurricane Maria Hospital Recovery Survey Wave 1

IC 254056 under ICR 202205-0693-002 · OMB 0693-0078.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0693-0078 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Hospital Survey Wave 1 _Instrument.pdf	Other-Survey
Hospital Survey Wave 1 _Instrument.pdf	Other-Survey
Hospital-Survey_Supporting-Statement_Wave1_PRA-Application.docx Supporting Statement	IC Document
Hospital-Survey_Supporting-Statement_Wave1_PRA-Application.docx Supporting Statement	IC Document
Hospital-Survey_Recruitment-Letter_Wave-1_PRA-Application.pdf Recruitment Letter	IC Document
Hospital-Survey_Recruitment-Letter_Wave-1_PRA-Application.pdf Recruitment Letter	IC Document
Hospital-Survey_Wave 1 telephone script.docx Scfipt	IC Document
Hospital-Survey_Wave 1 telephone script.docx Scfipt	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

NIST HURRICANE MARIA STUDY, HURRICANE MARIA RECOVERY OF CRITICAL SOCIAL FUNCTIONS PROJECT: HOSPITAL RECOVERY FOLLOWING HURRICANE MARIA HOSPITAL RECOVERY SURVEY WAVE 1

Agency IC Tracking Number:

IC Status: New

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
Other-Survey			Hospital Survey Wave 1 _Instrument.pdf		No		Printable Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Disaster Management

Subfunction: Disaster Repair and Restore

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 45

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	45	45
Annual IC Time Burden (Hours)	19	19
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement	Hospital-Survey_Supporting-Statement_Wave1_PRA-Application.docx	06/22/2022
Recruitment Letter	Hospital-Survey_Recruitment-Letter_Wave-1_PRA-Application.pdf	06/22/2022
Scfipt	Hospital-Survey_Wave 1 telephone script.docx	06/22/2022

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