World Trade Center (WTC) Health Program General Responder Consortium (GRC) Outreach Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NIOSH 2)

OMB: 0920-0953

IC ID: 219531

Information Collection (IC) Details

View Information Collection (IC)

World Trade Center (WTC) Health Program General Responder Consortium (GRC) Outreach Survey 16JG
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction NA World Trade Center Health Program Member Questionnaire - Telephone Survey GRCV1TelephoneScriptOMBrevised.docx NA Yes Yes Fillable Fileable
Form and Instruction NA World Trade Center Health Program Member Questionnaire - Paper Survey Attachment A- paper survey.docx NA No   Paper Only

Workforce Management Worker Safety

 

1,319 0
   
Individuals or Households
 
   70 %

  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 1,319 0 1,319 0 0 0
Annual IC Time Burden (Hours) 180 0 180 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
GenIC Request App-GRCOutreachSurvey.doc 01/08/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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