OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Stopping Elderly Accidents, Deaths, and Injuries (STEADI) in a Hospital Discharge Setting

IC 230187 under ICR 201612-0920-007 · OMB 0920-1009.

Documents and Forms
Document Name
Document Type
Other-WORD
Other-WORD
IC Document
IC Document
Information Collection (IC) Details

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Stopping Elderly Accidents, Deaths, and Injuries (STEADI) in a Hospital Discharge Setting 0920-1009 (18KW)
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-WORD Attachment C –Falls Prevention Participant Survey.docx Yes Yes Paper Only
Other-WORD Attachment B_Invitation Correspondence.docx No   Paper Only

Health Public Health Monitoring

 

1,532 0
   
Private Sector Businesses or other for-profits
 
   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 1,532 0 1,532 0 0 0
Annual IC Time Burden (Hours) 104 0 104 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Att A_D Intellix Award email (Privacy Determination) Att. A Privacy Act.pdf 02/20/2018
Request for Approval (0920-1005) GenIC_Request_STEADI Hospital Discharge Setting.docx 02/20/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.