Information Collection

Registration information and activity feedback from participants of meetings and workshops.

IC 272658 under ICR 202410-0906-002 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Registration information and activity feedback from participants of meetings and workshops.	Form and Instruction
1 Activity Registration HRSA IEA Activity Registration.pdf	Form and Instruction
2 Participant Follow-Up Form HRSA IEA Participant Follow-Up Form..pdf	Form and Instruction
3 Post-Activity Survey HRSA IEA Post-Activity Survey.pdf	Form and Instruction
Fast Track Memo - IEA Instruments.docx Fast Track Memo	IC Document

IC Title:

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Activity Registration	HRSA IEA Activity Registration.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	2	Participant Follow-Up Form	HRSA IEA Participant Follow-Up Form..pdf	Yes	Yes	Fillable Fileable
Form and Instruction	3	Post-Activity Survey	HRSA IEA Post-Activity Survey.pdf	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,700

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,700	2,700
Annual IC Time Burden (Hours)	150	150
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast Track Memo	Fast Track Memo - IEA Instruments.docx	11/26/2024

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