OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Employer Perspectives of an Insurer-Sponsored Wellness Grant

OMB 0920-1117 · HHS/CDC.

OMB 0920-1117

Latest Forms, Documents, and Supporting Material

Document Name
Wellness Grant_SSA clean.docx Supporting Statement A
Section B WWGP 20160104.docx Supporting Statement B
Attachment M Employer Participation Information sheet 20140610.docx Supplementary Document
Attachment L Information Security Plan 20151210.docx Supplementary Document
Attachment I IRB Renewal 01379_01251_01370_ HSRB 14-DSHEFS-01XP 2015.pdf Supplementary Document
Attachment H Letter of support from OHBWC.docx Supplementary Document
Attachment G NORA FY14 Intramural Funding Opportunity Announcements (JHoward).pdf Supplementary Document
Attachment F OHBWC WWGP Overview and Forms.pdf Supplementary Document
Attachment E - full research project description.docx Supplementary Document
Attachment D OBWC- NIOSH Letter of Agreement 5_04_12.docx Supplementary Document
Attachment C2 CDC-2014-0014-0005 - TWH agenda presentation & Fed Notice.pdf Supplementary Document
Attachment C1 NIOSH Strategic Goals for WWGP proj.docx Supplementary Document
Attachment B 2015-10286 - 60-day Federal Register for WWGP.pdf Supplementary Document
Attachment A Authorizing Legislation (2).docx Supplementary Document
Case Study Verification Interview Instruction
Employer Interview for Occupational Health and Safety Specialists Instruction
Employer Interview for Wellness Program Coordinators Instruction

All Historical Document Collections

201601-0920-005

Approved with change

New collection (Request for a new OMB Control Number)

2016-01-14