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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Tabletop Exercise-- Home Assessments for Patients and Families with Special Health Care Needs Developing Tools, Communication Strategies, and Standards
Agency IC Tracking Number:
0920-1154-22HH
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
Form and Instruction
0920-22HH
Att B Tabletop Exercise Question Bank and Guide (for Moderators)
Att B Tabletop Exercise Question Bank and Guide (for Moderators).docx
Yes
Yes
Fillable Fileable
Form and Instruction
0920-22HH
Att C Tabletop Exercise CYSHCN Feedback Form
Att C Tabletop Exercise CYSHCN Feedback Form.docx
Yes
Yes
Fillable Fileable
Form and Instruction
0920-22HH
AttD - Exercise Evaluation Form and Guide - CYSHCN TTX
AttD - Exercise Evaluation Form and Guide - CYSHCN TTX.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
32
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
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
32
0
32
0
0
0
Annual IC Time Burden (Hours)
102
0
102
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
GenIC Request
GenIC Request 0920-1154 Drexel CYSHCN TTX Jul2022.docx
07/19/2022
Appendix A - Situation Manual Home Assessment TTX
Appendix A - Situation Manual Home Assessment TTX.docx
07/19/2022
Appendix A1 - TTX presentation exercise Fall 2022
Appendix A1 - TTX presentation exercise Fall 2022.pptx
07/19/2022
Appendix B - Drexel TTX Save Date-Family Letter Fall 2022
Appendix B - Drexel TTX Save Date-Family Letter Fall 2022.docx
07/19/2022
Appendix E - TTX confirmation - Stakeholders Fall 2022
Appendix E - TTX confirmation - Stakeholders Fall 2022.docx
07/19/2022
Att A CDC Human Subjects Determination CYSHCN TTX
Att A CDC Human Subjects Determination CYSHCN TTX.pdf
07/19/2022
SSA
SSA_Drexel_CYSHCN_TTX Jul2022v1.docx
07/19/2022
SSB
SSB_Drexel_CYSHCN_TTX Jul2022.docx
07/19/2022
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.