Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Fatigue Management Training Module for Emergency Reponders Evaluation New 150 25 0 Other-PDF
Other-
Fatigue Management Training Module for Emergency Responders Evaluation New 150 25 0 Other-WORD
Other-WORD
Fatigue Prevention Training Module Customer Satisfaction and Feedback Survey New 150 38 0 Form and Instruction None NIOSH Fatigue Prevention Training Module Survey
Logistics Health Incorporated (LHI) New 6300 420 0 Other-WORD
Long Island WTC Health Program Survey New 4200 280 0 Form none Long Island Patient Satisfaction Survey
Manual of Analytical Methods Customer Satisfaction Survey New 500 250 0 Form none Manual of Analytical Methods Survey
North Shore LIJ Customer Satisfaction Survey New 2000 240 0 Form and Instruction None Medical Practice Survey
Survey #2 New 3000 500 0 Other-WORD
Instruction
Other-Screenshots
Survey to Improve Worker Notification Efforts New 3000 500 0 Form none Worker Notification Survey
Survey to Improve Worker Notification Efforts #3 New 3000 500 0 Form none Survey to Improve Worker Notification Efforts - #3
The Nationwide Provider Network Customer Satisfaction Survey New 6300 420 0 Other-WORD
The World Trade Center Health Program Customer Satisfaction Survey New 6500 1083 0 Form and Instruction 0920-0953 WTC Customer Satisfaction Survey
Form and Instruction 0920-0953 WTC screen shots
The World Trade Center Health Program for Responders at Rutgers University Customer Satisfaction Survey New 600 50 0 Form and Instruction 0920-0953 Patient Satisfaction Survey-Rutgers 12.10.13
World Trade Center (WTC) Health Program General Responder Consortium (GRC) Outreach Survey New 1319 165 0 Instruction
Form and Instruction None World Trade Center Health Program Member Questionnaire
World Trade Center (WTC) Health Program General Responder Consortium (GRC) Outreach Survey (Spanish and Polish versions) New 1 0 0 Form and Instruction None Members in the WTCHP General Responders Consortium--Spanish Version
Form and Instruction None Members in the WTCHP General Responders Consortium Polish Version
Total Burden Actually Used for Information Collections Under Currently Approved ICR: 37170 4496 0  
Total Burden Currently Requested for Information Collections Under Currently Approved ICR: 0 0 0  
To view an IC, click on IC Title