Information Collection

Hurricane Maria Recovery Of Critical Social Functions Project: Hospital Recovery Followng Hurricane Maria Hospital Recovery Interview Wave 1

IC 254334 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⚠️ Notice: This information collection may be referencing outdated material.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
0693-0078_Hospital Interview Wave 1 Script.docx	Other-Interview Script
0693-0078_Hospital Interview Wave 1 Script.docx	Other-Interview Script
0693-0078_Hospital Interview Wave 1 Supporting Statement.docx Supporting Statement	IC Document
0693-0078_Hospital Interview Wave 1 Supporting Statement.docx Supporting Statement	IC Document
0693-0078_Hospital Interview Outreach Communication.docx Recruitment	IC Document
0693-0078_Hospital Interview Outreach Communication.docx Recruitment	IC Document

IC Title:

HURRICANE MARIA RECOVERY OF CRITICAL SOCIAL FUNCTIONS PROJECT: HOSPITAL RECOVERY FOLLOWNG HURRICANE MARIA HOSPITAL RECOVERY INTERVIEW 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-Interview Script			0693-0078_Hospital Interview Wave 1 Script.docx		No		Paper Only

Line of Business: Disaster Management

Subfunction: Disaster Repair and Restore

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 15

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	15	15
Annual IC Time Burden (Hours)	15	15
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement	0693-0078_Hospital Interview Wave 1 Supporting Statement.docx	06/22/2022
Recruitment	0693-0078_Hospital Interview Outreach Communication.docx	06/22/2022

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