Healthcare Workers Core Module

Survey of Healthcare Workers' Health and Safety Practices

OMB: 0920-0860

IC ID: 192663

Documents and Forms
Information Collection (IC) Details

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Healthcare Workers Core Module
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 10 Healthcare Workers Core Module Attachment I9_Core Module_TC_72310.docx Yes Yes Fillable Fileable

Health Illness Prevention

 

20,520 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 20,520 0 20,520 0 0 0
Annual IC Time Burden (Hours) 6,840 0 6,840 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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