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View Information Collection (IC)

Knowledge, Attitudes, and Practices of Healthcare Professionals Working in Schools Regarding Tickborne Disease Prevention and Lyme Disease in New York State and Maryland 0920-1150-19AHT
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1150 HPWS Survey (online) Attachment_1_HPWS_Survey (Online).pdf Yes Yes Fillable Fileable
Form and Instruction 0920-1150 HPWS Survey (mail) Attachment_1_HPWS Survey (Mail).docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

3,951 0
   
Individuals or Households
 
   95 %

  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 3,951 0 3,951 0 0 0
Annual IC Time Burden (Hours) 264 0 264 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
HS Determination Attachment_2_Human_Subjects_010219AB.pdf 03/27/2019
NY Invitation Postcard Attachment_3_NY_Invitation_Postcard.pdf 03/27/2019
NY Invitation Flyer for mailing Attachment_4_NY_Invitation_Flyer_for_Mailing.pdf 03/27/2019
NY Invitation Flyer for email Attachment_5_NY_Invitation_Flyer_for_Email.pdf 03/27/2019
NY Reminder Postcard Attachment_6_NY_Reminder_Postcard.pdf 03/27/2019
NY Reminder Flyer for mailing Attachment_7_NY_Reminder_Flyer_for_Mailing.pdf 03/27/2019
NY Reminder Flyer for email Attachment_8_NY_Reminder_Flyer_for_Email.pdf 03/27/2019
MD Invitation Flyer for mailing Attachment_9_MD_Invitation_Flyer_for_Mailing.pdf 03/27/2019
MD Invitation Flyer for email Attachment_10_MD_Invitation_Flyer_for_Email.pdf 03/27/2019
MD Reminder Postcard Attachment_11_MD_Reminder_Postcard.pdf 03/27/2019
MD Reminder Flyer for email Attachment_12_MD_Reminder_Flyer_for_Email.pdf 03/27/2019
HPWS Project Website Attachment_13_HPWS_Project_Website.pdf 03/27/2019
MD IRB approval letter Attachment_14_MD IRB approval letter 030719.pdf 03/27/2019
NY IRB Approval letter Attachment_15_NY_IRB_Approval_Letter.pdf 03/27/2019
SSA SS A_GenIC_SBHP final.docx 03/27/2019
SSB SS B_GenIC_SBHP.docx 03/27/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.