Nurse Corps Evaluation: Participant and Alumni Survey

Bureau of Health Workforce Nurse Corps Supplemental Funding Evaluation

Documents and Forms

Document Name Document Type
Form 3 Nurse Corps Evaluation: Participant and Alumni Survey Form and Instruction
3 Nurse Corps Evaluation: Participant and Alumni Survey Nurse Corps Participant and Alumni Survey.docx Form and Instruction
3 Nurse Corps Evaluation: Participant and Alumni Survey Nurse Corps Participant and Alumni Survey.docx Form and Instruction
4 Outreach for Nurse Corps Evaluation: Participant and Alu Outreach Materials for Participant and Alumni Survey.docx Form and Instruction
4 Outreach for Nurse Corps Evaluation: Participant and Alu Outreach Materials for Participant and Alumni Survey.docx Form and Instruction
5 INTRODUCTORY CALL SCRIPT FOR TELEPHONE ADMINISTRATION Telephone Follow-up Introduction.docx Form and Instruction
5 INTRODUCTORY CALL SCRIPT FOR TELEPHONE ADMINISTRATION Telephone Follow-up Introduction.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Nurse Corps Evaluation: Participant and Alumni Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	3	Nurse Corps Evaluation: Participant and Alumni Survey	Nurse Corps Participant and Alumni Survey.docx	Yes	Yes	Fillable Fileable
Form and Instruction	4	Outreach for Nurse Corps Evaluation: Participant and Alumni Survey	Outreach Materials for Participant and Alumni Survey.docx	Yes	Yes	Fillable Fileable
Form and Instruction	5	INTRODUCTORY CALL SCRIPT FOR TELEPHONE ADMINISTRATION	Telephone Follow-up Introduction.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 7,302	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	7,302	7,302
Annual IC Time Burden (Hours)	3,067	3,067
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.