Post-Training (1, 3, and 6-months) Survey

Nurse Fatigue-Mitigation Education: Does it Change Nurse Sleep Behavior?

Documents and Forms

Document Name Document Type
Form 0920-21FC Post-Training (1, 3, and 6-months) Survey Form and Instruction
0920-21FC Post-Training (1, 3, and 6-months) Survey Attachment D.3 SURVEY FOR POST-TRAINING (1, 3, AND 6-MONTHS).docx Form and Instruction
0920-21FC Post-Training (1, 3, and 6-months) Survey Attachment D.3 SURVEY FOR POST-TRAINING (1, 3, AND 6-MONTHS).docx Form and Instruction

Information Collection (IC) Details

IC Title:	Post-Training (1, 3, and 6-months) Survey	Agency IC Tracking Number:	0920-21FC

Is this a Common Form? Yes		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-21FC	Post-Training (1, 3, and 6-months) Survey	Attachment D.3 SURVEY FOR POST-TRAINING (1, 3, AND 6-MONTHS).docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	40	40
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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