Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
ASPR TRACIE Webinar Polling New 6000 300 0 Other-Polling Consent Guide
Other-survey
Adolescent SBIRT (A-SBIRT) In-Person Training Feedback Surveys: a) Satisfaction and Retrospective Knowledge and Awareness Survey b) A-SBIRT 3 month/6 month Usage Feedback Survey(s) New 500 175 0 Other-survey
Other-Survey
Other-survey
Adolescent SBIRT (A-SBIRT) Online Training (Kognito) Feedback Surveys New 1000 400 0 Other-follow up survey
Other-Post survey
Other-Pre Survey
Azalea Prevention Project New 3650 913 0 Other-follow-up survey
Other-survey
Other-survey
Bureau of Health Workforce (BHW) Website Card Sort New 50 17 0 Instruction
Card Sort Online Data Collection for Grants.gov New 1000 250 0 Other-survey
Comments on the Cybersecurity in the healthcare and public health sector New 45 270 0 Other-forms
Other-forms
Other-Guide
FDA.gov Card Sort Online Survey New 50 13 0 Other-form
Feedback onTopics of Interest for the Provision of technical assistance for Teen Pregnancy Prevention Program Grantees in FY2019 New 58 10 0 Other-survey and instruction
HRSA Bureau of Health Workforce (BHW) Site Admin Portal Satisfaction Survey New 1100 92 0 Other-survey
HRSA Health Workforce Connector (HWC) Satisfaction Survey New 5000 417 0 Other-survey
HRSA In-Page Web Survey New 50000 2500 0 Other-survey
HRSA Web Survey for Bureau of Health Workforce (BHW) program participants New 5000 250 0 Other-Survey
Health IT Website Satisfaction Survey New 12796 427 0 Other-form
Health and Human Services (HHS) Office of the Assistant Secretary for Health (OASH) Region 4, Raising Awareness of Human Trafficking Among School Personnel Training End-of-Course Evaluation New 7326 1832 0 Other-survey
HealthIT.gov Website Satisfaction Survey New 5121 854 0 Other-survey
Home Health and Hospice Survey and Interviews New 250 75 0 Other-survey
Other-guide
Join the Healthcare and Public Health (HPH) Risk Identification and Site Criticality (RISC) Toolkit Mailing List New 3800 63 0 Other-survey
ODPHP Website Visitor Satisfaction Site- and Page-Level Surveys New 132000 4600 0 Other-questionnaire
Other-survey
Other-screenshots
OWH Prevention Award - Provider Qualitative Interviews New 25 13 0 Other-Interview
OWH Prevention Award - SBIRT Provider Knowledge and Confidence Survey New 100 33 0 Other-Survey
OWHPA Grantee Cross-Site Evaluation New 40 40 0 Other-Survey Instrument- Grantee
Other-Surey Instrument- Program Partner
Office of Adolescent Health Annual Grantee Satisfaction Survey New 228 76 0 Other-survey with instructions
Office of Adolescent Health Grantee Group Training and Technical Assistance Satisfaction Survey New 2368 118 0 Other-survey and script
Office of Adolescent Health Individual Technical Assistance Grantee Satisfaction Surveys New 15 1 0 Other-survey and instructions
Office of Population Affairs (OPA) Title X Grantee Needs Assessment Survey New 1680 420 0 Other-needs assessment survey with scripts and instructions
Office of Population Affairs Teen Pregnancy Prevention and Pregnancy Assistance Fund Grantee Satisfaction Survey New 145 48 0 Other-survey and scripts
Office on Women's Health Youth Engagement in Sports (YES) Initiative Online Survey New 144 180 0 Other-YES Initiative Survey Instrument
PHE.gov Satisfaction Surveys: Exit Survey and In-Page Survey New 800 67 0 Other-survey
Other-SURVEY
Peer Support and Pain Self-Management Education Program Feedback New 66 22 0 Other-evaluation
Promoting Older Women's Engagement in Recovery (POWER) Post Training Survey New 165 14 0 Other-trainiing
Promoting Older Women's Engagement in Recovery (POWER) Post Training Surveys New 515 46 0 Other-training survey
Other-survey SBIRT
Other-Opioids training
Other-survey
Other-3 month follow-up training
Other-Opioids Follow up
Other-Follow-upProvider MI Survey
Other-Follow-up SBIRT
Promoting Older Women's Engagement in Recovery (POWER) Seeking Safety Training Survey New 10 1 0 Other-survey
Qualitative Research for Medical Community Baselining Phase II New 360 360 0 Other-guide
Other-Screener
Region IX Office of the Regional Health Administrator (ORHA) External Customer Satisfaction Survey New 500 25 0 Other-survey
Request for feedback from Teen Pregnancy Prevention Program (TPP) Grantees on the technical assistance (TA) and training provided to them by the Office of Adolescent Health (OAH) New 1936 355 0 Other-survey
Rowan University School of Osteopathic Medicine (SOM) New 300 25 0 Other-PRE Assessment
Other-Satisfaction Survey
Other-Satisfaction for Medical students
Other-Post Assessment
Other-Assessment Medical Students
Other-Pre Assessment Residents
Other-Pre-Assessment Medical Students
Other-Qualtrics
STEP Post Survey New 175 15 0 Other-survey
STEP Pre Survey New 175 9 0 Other-survey
Surveys for Building Your Wellness Toolbox (A six week psycho-educational group as part of the Promoting Older Women's Engagement in Recovery project) New 131 17 0 Other-survey
Other-survey
Other-survey
Other-survey
Other-survey
Other-survey
Surveys to Inform Service Delivery Improvement of Teen Intervene Curriculum with Mental Health Providers and Adolescent Clients New 57 5 0 Other-survey
Other-survey
Tree Testing FDA.Gov New 50 13 0 Other-survey
Tree Testing for Grants.Gov New 1000 250 0 Other-survey
Womenshealth.gov Homepage Redesign Testing New 1008 168 0 Other-Screener
Other-Mockup-mobile
Other-Mockup-desktop
Other-Mockup-menu
Youth Listening Session Grantee Satisfaction Survey 2019 New 10 3 0 Other-survey and instructions
www.medicalcountermeasures.gov customer site feedback form New 100 8 0 Other-questionnaire
Total Burden Actually Used for Information Collections Under Currently Approved ICR: 246849 15790 0  
Total Burden Currently Requested for Information Collections Under Currently Approved ICR: 0 0 0  
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