NASA Enterprise Salesforce COVID-19 Contact Tracing

Documents and Forms

Document Name Document Type
Guided Script - Positive Outreach_v2.3 (1).docx nasahealth--nasahltuat.my.salesforce.com Other-Data Collection
Guided Script - Positive Outreach_v2.3 (1).docx nasahealth--nasahltuat.my.salesforce.com Other-Data Collection
Guided Script - Contact Tracing_v2.3 (1).docx nasahealth--nasahltuat.my.salesforce.com Other-Data Collection
Guided Script - Contact Tracing_v2.3 (1).docx nasahealth--nasahltuat.my.salesforce.com Other-Data Collection

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	NASA Enterprise Salesforce COVID-19 Contact Tracing	Agency IC Tracking Number:

Is this a Common Form? Yes		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 42 CFR 2 14 CFR 1212.605

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Data Collection			Guided Script - Positive Outreach_v2.3 (1).docx	https://nasahealth--nasahltuat.my.salesforce.com	No		Paper Only
Other-Data Collection			Guided Script - Contact Tracing_v2.3 (1).docx	https://nasahealth--nasahltuat.my.salesforce.com	Yes	Yes	Fillable Fileable

Line of Business: General Science and Innovation

Subfunction: Scientific and Technological Research and Innovation

Privacy Act System of Records
Title: NASA 10 HIMS, Health Information Management System	FR Citation: 85 FR 79224

Number of Respondents: 5,400	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	5,400	0	5,400
Annual IC Time Burden (Hours)	2,700	0	2,700
Annual IC Cost Burden (Dollars)	118,800	118,800	0

Documents for IC

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.