OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Healthcare Worker - Follow-Up Survey

IC 261470 under ICR 202404-0920-001 · OMB 0920-1415.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Healthcare Worker - Follow-Up Survey
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction NA Healthcare Worker - Follow-Up Survey 4 Healthcare worker follow-up survey.docx NA Yes Yes Fillable Fileable
Form and Instruction 0920-1415 Healthcare Worker - Follow-Up Survey 4 Healthcare worker follow-up survey_proposed changes_clean.docx N/A Yes Yes Fillable Fileable

Workforce Management Worker Safety

 

12,000 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 12,000 0 0 0 0 12,000
Annual IC Time Burden (Hours) 2,000 0 0 0 0 2,000
Annual IC Cost Burden (Dollars) 6,435 0 0 0 0 6,435

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.