Information Collection

Foil the Flu Survey (ORS/OD)

IC 259473 under ICR 202307-0925-002 · OMB 0925-0648.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Foil the Flu Survey (ORS/OD)	Form
1 screenshots OMS Foil the Flu Survey Screenshots UPDATED.docx	Form
Administration Email_Foil the Flu (002).docx email invite	IC Document
fast track template Foil the Flu final.docx Template	IC Document

IC Title:

Foil the Flu Survey (ORS/OD)

Agency IC Tracking Number:

IC Status: Unchanged

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
Form	1	screenshots	OMS Foil the Flu Survey Screenshots UPDATED.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 30,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	30,000	30,000
Annual IC Time Burden (Hours)	2,500	2,500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
email invite	Administration Email_Foil the Flu (002).docx	04/05/2023
Template	fast track template Foil the Flu final.docx	04/06/2023

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