OMB control number

CDC Work@Health Program: Phase 2 Training and Technical Assistance Evaluation

OMB 0920-1006 · HHS/CDC.

OMB 0920-1006

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Trainee Technical Assistance SurveyForm
Train the Trainee Technical Assisstance SurveyForm
Instructor Discussion GuideForm and Instruction
Trainer Reaction SurveyForm
Train the Trainer Reaction SurveyForm
Train the Trainer Participant SurveyForm
Train the Trainer ApplicationForm
Trainee Focus Group GuideForm and Instruction
Case Study Interview Guide with TraineesForm and Instruction
Trainee Reaction SurveyForm
Trainee Reaction SurveyForm
Trainee Reaction SurveyForm
Trainee KAB SurveyForm
Case Study Interview Guide with EmployeesForm and Instruction
Case Study Interviews Guide with LeadershipForm and Instruction
Employer Follow-up SurveyForm
Organizational AssessmentForm
Worksite Health ScorecardForm
Employer ApplicationForm
Work@Health Extension SS_B 12-18-15.docSupporting Statement B
Work@Health SS_A 01062016.docSupporting Statement A
Att J_Employer Training_FAQ.doc Supplementary Document
Att D_Data Collection Flowchart_12-14-15.doc Supplementary Document
Att C_Objective-Survey Instrument Crosswalk.doc Supplementary Document
Att B-2_Summary of Public Comments.docx Supplementary Document
Att B-1_60-day FRN 8 04 2015.pdf Supplementary Document
A-3_PHSA Rsch.pdf Supplementary Document
A-2_Funding Authority_ACA.pdf Supplementary Document
A-1_Authorizing Legislation_EBWP.docx Supplementary Document
Trainee Technical Assistance Survey Form
Train-the-Trainer Technical Assistance Survey Form
Instructor/Coach Group Discussion Guide Form and Instruction
Wave 2 Trainee Reaction Survey Form
Train-the-Trainer Reaction Survey Form
Train-the-Trainer Participant Survey Form
Train-the-Trainer Application Form Form
Trainee Focus Group Discussion Guide Form and Instruction
Case Study Interviews with Selected Trainees Form and Instruction
Trainee Reaction Survey Blended Model Form
Trainee Reaction Survey - Online Model Form
Trainee Reaction Survey- Hands-On Model Form
Trainee KAB Survey Form
Case Study Interviews with Employees Form and Instruction
Case Study Interviews with Senior Leadership Form and Instruction
Employer Follow-up Survey Form
Organizational Assessment Form
CDC Worksite Health Scorecard Form
Employer Application Form Form

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
201512-0920-008 Revision of a currently approved collection 2016-01-11 Approved without change
201410-0920-013 No material or nonsubstantive change to a currently approved collection 2014-10-27 Approved without change
201312-0920-004 New collection (Request for a new OMB Control Number) 2013-12-05 Approved with change