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Assessment of Get Ahead of Sepsis Camplaign - Health Care Providers 0920-0572-20HM
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none GAOS Pretest - Health care providers Attachment D_GAOS HCP Survey_1.24.20_FINAL PRETEST.docx Yes Yes Fillable Fileable
Form none GAOS - Posttest - Health care providers Attachment F_GAOS HCP Survey_1.24.20_FINAL POSTTEST.docx Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

450 0
   
Individuals or Households
 
   100 %

  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 450 0 450 0 0 0
Annual IC Time Burden (Hours) 113 0 113 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Assessment overview Attachment A_GAOS Pilot Assessment Overview_HCPs.docx 02/10/2020
Incentive justification Attachment B_GAOS HCP Incentive Justification.docx 02/10/2020
Recruitment invitation Attachment C_GAOS HCP Recruitment Invitation.docx 02/10/2020
Research determination Attachment H_GAOS Consumer and HCP Exempt 12.20.19.pdf 02/10/2020
Assessment materials Attachment I_GAOS HCP Materials for 2020 Assessment FINAL.pdf 02/10/2020
Pretest - screenshots Attachment E_GAOS HCP Survey PRE-TEST HMTS.pdf 02/12/2020
Posttest- screenshots Attachment G_GAOS HCP Survey POST-TEST HMTS.pdf 02/12/2020
genIC Review form HMTS Expedited Review Form - GAOS HCP Assessment.pdf 02/12/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.