Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
2016 Science Ambassador Workshop Satisfaction Survey New 30 10 0 Form and Instruction NA 2016 Science Ambassador Workshop Satisfaction Survey
2017 Science Ambassador Fellowship Summer Course Satisfaction Survey New 30 10 0 Form and Instruction 0920-17ANW Att_1_0920-1050_2017_Science_Amb_Fwshp_Sum_Course_Cust_Sat_Survey_Subm
Form and Instruction 0920-17ANW Att_2_0920-1050_2017_Science_Amb_Fwshp_Sum_Course_Cust_Sat_Survey_Screen...
2018 CUPS/Ferguson Summer Showcase New 744 99 0 Form none Session 2 survey
Form none Session 1 survey
Form none Session 3 survey
2018 Federal Select Agents Program Inspection Feedback Survey New 264 44 0 Form 0920-1050 2019 Federal Select Agent Program Inspection Feedback Survey
2018 ITSO Customer Satisfaction Survey New 2400 600 0 Form none 2018 ITSO Customer Satisfaction Survey
2018 Public Health Ethics Forum New 100 8 0 Form and Instruction 0920-1050 PHE Forum Survey
2018 Science Ambassador Fellowship Exit Satisfaction Survey New 30 5 0 Form and Instruction 0920-1050 Science Ambassador Fellowship Exit Satisfaction Survey - Screenshot
2018 Science Ambassador Fellowship Summer Course Satisfaction Survey New 30 5 0 Form n/a 2018 Science Ambassador Fellowship Summer Course Satisfaction Survey
Other-Reference document: Word version of survey content
2019 Science Ambassador Fellowship Regional Training Workshop Customer Satisfaction Survey New 100 10 0 Other-WORD
Form and Instruction 0920-1050 Science Ambassador Regional Training Workshop Satisfaction Survey
APIH Fellowship Program Orientation Survey New 30 3 0 Form 0920-1050 APIH - ASPPH ORIENTATION SURVY
Form 0920-1050 APIH - AACN ORIENTATON SURVEY
Academic Partnerships to Improve Health (APIH) Program Training/Workshop Feedback Survey (January – June, 2019) New 180 15 0 Form n/a APIH Training Feedback Survey
Adapting Clnical Guidelines for the Digital Age Meeting Assessment New 232 39 0 Form none Assessment
Assessing Customer Satisfaction with Health, US Report New 50 25 0 Other-Interview guide
CDC DataViz Day Needs Assessment New 469 39 0 Form and Instruction 0920-1050 DataViz Day Needs Assessment
CDC Fellowships, Internships, and Learning Opportunities GovDelivery Newsletter Customer Satisfaction Survey New 1200 40 0 Form and Instruction 0920-1050 Customer Satisfaction Survey: CDC Fellowships, Internships, and Learning Opportunities GovDelivery (GovD) Newsletter - Screenshot
CDC Latent Tuberculosis Infection Mobile App Survey New 200 33 0 Form and Instruction 0920-17AUP Attachment A_LTBI Mobile App Survey Questions
Form and Instruction 0920-17AUP Attachment B_LTBI Mobile App Survey_Current Users_Screenshots
Form and Instruction 0920-17AUP Attachment C_LTBI Mobile App Survey_Potential Users_Screenshots
CDC Learning Connection Gov D Newsletter Survey New 2000 33 0 Other-Screenshots
Form and Instruction 0920-1050 GOV.D Survey Questions
CDC Page Info Tab New 65 11 0 Form and Instruction 0920-1050 CUSTOMER SATISFACTION SURVEY: CDC’S PAGE INFO TAB
CDC Public Health Emergency Management Fellowship Feedback New 30 30 0 Form and Instruction 0920-1050 PHEMF Feedback
CDC Public Health Grand Rounds Audience Satisfaction Survey New 3000 250 0 Form none Public Health Grand Rounds Survey
CDC Solve the Outbreak Mobile App New 400 67 0 Form N/A Solve the Outbreak (General Public version)
Form N/A Solve the Outbreak (Teacher version)
Form N/A Solve the Outbreak (Student version)
CDC Template Navigation New 50 50 0 Other-Discussion guide
CDC Zika Website New 50 50 0 Form and Instruction NA CDC Zika website User Experience (UX): Questionnaire
Form and Instruction NA ZIKA USABILITY TEST: NOTETAKING DOCUMENT
CDC-INFO Email Survey New 9000 900 0 Form none CDC-INFO Email Survey
CDC-INFO Interactive Voice Response Survey New 1296000000 2400 0 Form and Instruction 0920-1050 17FZ
Customer Feedback on CDC CVD Policy Platform New 50 25 0 Other-WORD
Customer Satisfaction Survey for 5 CDC Laboratories Seeking ISO 17025 Accreditation for Laboratory Quality New 4300 717 0 Form N/A CDC Laboratory Cusomter Satisfaction Survey (paper version)
Form N/A CDC Laboratory Customer Satisfaction Survey (web version)
Customer Service Feedback Survey of 2017 EIS Conference New 750 125 0 Form and Instruction NA 2017 EIS Conference Customer Service Feedback Survey - Screenshot
Customer Service Feedback Survey of 2018 EIS Conference New 750 25 0 Form and Instruction 0920-1050 EIS Conference Customer Service Feedback Survey - Screenshots
Disaster Response Training Needs Assessment New 1000 333 0 Form and Instruction 0920-1050 Needs Assessment
Education and Training Services Branch Customer Satisfaction Survey New 200 17 0 Form none Customer Satisfaction Survey
Emergency Partners Information Connection (EPIC) Partner Interaction New 80 13 0 Other-Survey script
FLU Vaccines Section Usability Testing New 400 67 0 Other-Screenshots
Instruction
Instruction
Feedback for 2018 Place & Health Conference New 100 8 0 Form and Instruction 0920-1050 Feedback for 2018 Place & Health Conference
ITSO Customer Satisfaction Survey New 2400 600 0 Form and Instruction NA 2017 ITSO Customer Satisfaction Survey - Domestic
Form and Instruction NA 2017 ITSO Customer Satisfaction Survey - Global
MosquitoNet Surveillance System Focus Group New 200 400 0 Form and Instruction 0920-1050 MosquitoNET Focus Group Discussion Guide
National Diabetes Prevention Program Customer Service Center (National DPP CSC) -- Customer Satisfactory Surveys New 3000 50 0 Form and Instruction 0920-1050 National DDP Customer Service Center -- Surveys Along the Customer Journey
Office of Scientific Integrity Customer Satisfaction Survey New 287 96 0 Form none Customer Satisfaction Survey
Participant Assessment of Science Integrity Branch Trainings New 150 25 0 Form none Training Assessment
Partner Feedback Assessment Of Sexually Transmitted Disease (STD) Clinic Processes For Conducting And Documenting Routine HIV Testing New 25 25 0 Form and Instruction NA DSTDP Assessment: HIV testing in SSuN STD Clinics - STD Clinic Provider Interview Guide
Form and Instruction NA DSTDP Assessment: HIV testing in SSuN STD Clinics - STD Clinic/Data Manager Interview Guide
Post-Meeting Survey of Attendees at the 2018 Childhood Lead Poisoning Prevention Annual Cooperative Agreement Recipient's Meeting New 150 13 0 Form and Instruction 0920-1050 0920-1050
Seasonal Flu: Email Updates Satisfaction Survey New 100 8 0 Form and Instruction NA Flu Email Updates Survey
Special Emphasis Panel (SEP) Peer Review Evaluation New 350 88 0 Form and Instruction 17WN Att 1. Instrument_Peer Reviewers' Evaluation Form 3.2.17
TB Training and Education Needs Assessment of the US-affiliated Pacific Islands and Hawaii New 200 50 0 Form none TB Survey - word
Form none TB Survey - screenshots
Technical Packages for Violence Prevention Using Evidence-based Strategies in Your Violence Prevention Efforts Online Survey New 861 72 0 Form none Technical Package Violence Prevention Survey
Understanding the Use of CDC Resources and Tools during 2017 Hurricane Disaster Response New 50 50 0 Other-WORD (English)
Other-WORD (Spanish Version)
Web Usability Study for CDC's Radiation Emergencies Website New 108 46 0 Other-WORD
Other-WORD
Instruction
Instruction
Total Burden Actually Used for Information Collections Under Currently Approved ICR: 1296036195 7629 0  
Total Burden Currently Requested for Information Collections Under Currently Approved ICR: 0 0 0  
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