View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Assessing Key Factors to Pharmacy Enrollments in the Vaccines for Children Program	Agency IC Tracking Number:	15BK

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-WORD			B_Interview Guide.docx		No		Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 30	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	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	30	0	30	0	0	0
Annual IC Time Burden (Hours)	24	0	24	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement A	EUH8-VFC-SSA.docx	10/14/2014
Supporting Statement B	EUH8-VFC-SSB.docx	10/14/2014
Att A-Infographic Summary	A_VFC Infographic.pdf	10/14/2014
Att C - ASTHO Report Summary	C_ASTHO Summary.pdf	10/14/2014
Att D-VFC Project Overview	D_VFC Project Overview.pdf	10/14/2014
Att E-Participants Notification Email	E_Participant Notification Email.docx	10/14/2014
Att F-SHO Notification Email	F_SHO Notification Email.docx	10/14/2014
Att G-Reminder E-mail	G_Reminder Email.docx	10/14/2014
Att H-Confirmation Email	H_Confirmation Email.docx	10/14/2014
Att I-Thank You E-mail	I_Thank You Email.docx	10/14/2014

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.