Building Diagnostic Safety Capacity - Diagnostic Calibration Resource Evaluation Plan

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

OMB: 0935-0179

IC ID: 247238

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Building Diagnostic Safety Capacity - Diagnostic Calibration Resource Evaluation Plan
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Appendix A: Individual Respondent Characteristics Survey Appendix A_Respondent Characteristics_final.docx No   Paper Only
Form and Instruction 2 Appendix B: Safety Attitude Survey Appendix B_Safety Attitude Survey_final.docx No   Paper Only
Form and Instruction 3 Appendix C: Pre-Test Interview Protocol Appendix C_Pre-test Interview Protocol_final.docx No   Paper Only
Form and Instruction 4 Appendix D: Post-test Evaluation Interview Protocol Appendix D_Post-test Interview Protocol_final.docx No   Paper Only
Form and Instruction 1a Appendix A_Respondent Characteristics_final_6 17 21 Appendix A_Respondent Characteristics_final_6 17 21.docx No   Paper Only
Form and Instruction 3a Appendix C_Pre-test Interview Protocol_final_ 6 17 21 Appendix C_Pre-test Interview Protocol_final_ 6 17 21.docx No   Paper Only
Form and Instruction 4a Appendix D_Post-test Interview Protocol final 6 17 21 Appendix D_Post-test Interview Protocol final 6 17 21.docx No   Paper Only

Health Health Care Services

 

80 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   0 %

  Requested 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 80 0 0 0 0 80
Annual IC Time Burden (Hours) 50 0 0 0 0 50
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Cover Letter OMB Cover Letter.docx 05/07/2021
Supporting Statement Resoure 5A OMB_Supporting Statement A_final_v2.docx 05/07/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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