Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Assessing and Evaluating the Effectiveness of Hazard Recognition and Risk Assessment Interventions New 670 247 0 Other-WORD
Other-WORD
Other-WORD
Other-WORD
Other-WORD
Other-WORD
Other-WORD
Other-WORD
Assessment of Personal Protective Equipment Information Database Needs and Capabilities New 100 100 0 Form 0920-0953 PPE (Personal Protective Equipment) Survey
Assessment of Personal Protective Equipment Information Database Needs and Capabilities New 100 100 0 Form 0920-0953 PPE Survey
Improve Worker Notification Efforts: Survey #1 New 3000 500 0 Form none Survey #1
Improve Worker Notification Efforts: Survey #2 New 3000 500 0 Form none Survey 2 Screenshots
Improve Worker Notification Efforts: Survey #3 New 3000 500 0 Form none Survey #3
Long Island World Trade Center Health Program Customer Satisfaction Survey New 4200 280 0 Form and Instruction NA Patient Satisfaction Survey
NIOSH Center for Motor Vehicle Safety Needs Assessment and Audience Analysis New 36 72 0 Other-WORD
Other-WORD
Other-WORD
NORA Agriculture Forestry and Fishing Council New 80 40 0 Form and Instruction 0920-17EO NORA AFF SC questionnaire_Appendix 2
NORA Agriculture, Forestry, and Fishing Sector Council Feedback through Focus Groups New 10 20 0 Other-Focus Group Guide
NORA Agriculture, Forestry, and Fishing Sector Council Feedback through Informant Interviews New 15 15 0 Other-Interview Guide
NORA Oil and Gas Extraction Council Questionnaire New 64 16 0 Form and Instruction NA NORA Oil and Gas Research Agenda Questionnaire
NORA Services Sector Council Questionnaire New 27 7 0 Form and Instruction 0920-0953 National Occupational Research Agenda (NORA)
North Shore LIJ Customer Satisfaction Survey New 2000 240 0 Form none Customer Satisfaction Survey
North Shore LIJ Customer Satisfaction Survey New 8000 240 0 Form and Instruction 0920-0953 Queens2018update
SUNY – Stony Brook CCE WTC Health Program Customer Satisfaction Survey New 1900 158 0 Form and Instruction 0920-0953 Member Survey - 2018
The Nationwide Provider Network Customer Satisfaction Survey New 6300 420 0 Form none Survey
The World Trade Center (WTC) Health Program Call Center Satisfaction Survey New 79050 1318 0 Form and Instruction NA WTCHP Call Center Stisfaction Survey - Program Members
Form and Instruction NA WTCHP Call Center Stisfaction Survey - Clinical Centers of Excellence
Form and Instruction NA WTCHP Call Center Stisfaction Survey - Health Providers
Form and Instruction NA WTCHP Call Center Stisfaction Survey - Pharmacists
The World Trade Center (WTC) Health Program Customer Satisfaction Survey New 25000 6250 0 Form N/A World Trade Center Health Program Member Feedback Questionnaire
Three Occupation-specific Units for the Workplace Violence Course: Focus Group Discussions for the Stand-alone Facilities, Home Health/Social Services, and Emergency Responder units New 48 144 0 Form and Instruction 0920-0953 Focus Group Discussion Guide Attachment A
Total Worker Health Capacity Building Letter New 235 20 0 Other-WORD
User Feedback Questionnaire for ERHMS Info Manager New 65 16 0 Other-WORD
WTC Health Program for Responders at Rutgers University New 600 50 0 Form none Patient Survey
WTCH Routine Customer Feedback New 16000 1333 0 Form and Instruction 0920-0953 5-WB2811-Evaluation (3)
Worker Notification Feedback Survey New 3000 500 0 Other-WORD
World Trade Center (WTC) Health Program General Responder Consortium (GRC) Outreach Survey New 1319 180 0 Form and Instruction NA World Trade Center Health Program Member Questionnaire - Paper Survey
Form and Instruction NA World Trade Center Health Program Member Questionnaire - Telephone Survey
Total Burden Actually Used for Information Collections Under Currently Approved ICR: 157819 13266 0  
Total Burden Currently Requested for Information Collections Under Currently Approved ICR: 0 0 0  
To view an IC, click on IC Title