Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Economic Indicators New 23 23 0 Form and Instruction 0920-21GB Economic Indicators
Emergency Department Injury Indicators New 23 115 0 Form and Instruction 0920-21GB Emergency Dept Injury Indicators
Hospital Discharge Injury Indicators New 23 115 0 Form and Instruction 0920-21GB Hospital Discharge Injury Indicators
Implementation Capacity Rubric New 23 46 0 Form and Instruction 0920-21GB Implementation Capacity Development Rubric
Injury Indicators New 23 115 0 Form and Instruction 0920-21GB Death Injury Indicators Spreadsheet
Recipient-level Group Interviews New 23 35 0 Form and Instruction 0920-21GB Recipient Level Group Interviews
Special Emphasis Reports New 23 230 0 Form and Instruction 0920-21GB Special Emphasis Report Examples
Total burden requested under this ICR: 161 679 0  
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