Information Collection

Participant Post-Activity Immediate Survey

IC 272958 under ICR 202412-0906-005 · OMB unassigned.

Documents and Forms

Document Name Document Type
Form 5 Participant Post-Activity Immediate Survey Form and Instruction
5 Participant Post-Activity Immediate Survey PPA_30 day_Final.pdf Form and Instruction
5 PPA_finaldraftOMB 05.29.2025 PPA_finaldraftOMB 05.29.2025.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Participant Post-Activity Immediate Survey	Agency IC Tracking Number:

Is this a Common Form? No		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	5	PPA_finaldraftOMB 05.29.2025	PPA_finaldraftOMB 05.29.2025.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 59,576	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 80 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	178,728	178,728
Annual IC Time Burden (Hours)	10,724	10,724
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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