Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Bureau of Primary Health Care (BPHC) Website Card Sort Unchanged 35 18 0 Other-Survey-test script
Listening Sessions with Quality Family Planning (QFP) End Users New 120 120 0 Other-Questions for the Listening Sessions
: Office of the Assistant Secretary for Health Office of Disease Prevention and Health Promotion External Customer Satisfaction Survey New 22500 1875 0 Form and Instruction ODPHP External Customer Satisfaction Survey Customer Satisfaction Survey
ADVANCING THE RESPONSE TO COVID-19: SHARING PROMISING PROGRAMS AND PRACTICES FOR RACIAL AND ETHNIC MINORITY COMMUNITIES VIRTUAL SYMPOSIUM WEBINAR ASSESSMENT Unchanged 1500 375 0 Other-Survey
ASPR Candidate Experience Survey Unchanged 1000 83 0 Other-survey
ASPR Listening Sessions Unchanged 350 217 0 Other-Registration Form
Bureau of Health Workforce (BHW) Website Usability Testing Unchanged 30 15 0 Other-Test Script instrument
COVID-19 VIRTUAL LEARNING SESSIONS FEEDBACK ASSESSMENT Unchanged 200 50 0 Other-learning session
Covid.gov - On Page - All Devices New 130182 10849 0 Other-survey
Customer Experience in Customer Experience in Funding Opportunity Service Delivery New 1400 650 0 Other-
Other-
Other-
Other-
Customer Feedback on Previously Developed Health Messaging to Promote Vaccination Among Older African American Community Health Workers Unchanged 500 125 0 Other-Questionnaire
Department of Health and Human Services/ Assistant Secretary for Public Affairs/ Email Marketing Subscriber Survey New 10000 833 0 Other-survey
Federal Office of Rural Health Policy (FORHP) Website Card Sort Unchanged 30 15 0 Other-card sort script
Focus Group Feedback OPA Adolescent Health Strategic Plan Unchanged 250 500 0 Other-Focus Group Questions
Generic Clearance for the Collection of Routine Customer Feedback" ODPHP Online Customer Surveys New 44000 1534 0 Other-ODPHP Website Screener
Other-Website site and page level survey protocol
Other-Site level Question Bank
Other-ODPHP Web Survey Screenshots
HHS.gov Continuous Improvement Survey Unchanged 50 13 0 Other-survey
HRSA Division of Transplantation (DoT) Concept Testing Unchanged 60 105 0 Form and Instruction 1 Informed Consent: DoT Concept Testing
Instruction
Instruction
HRSA HIV/AIDS Bureau (HAB) Website Card Sort Unchanged 30 15 0 Other-HAB cart test script
Interviews for OPA Adolescent Health National Strategic Plan Development Unchanged 20 20 0 Other-structured interview guide
Interviews for OPA Quality Family Planning 2.0 Report New 20 30 0 Other-Interview Script
Intranet Customers Feedback Modified 1250 63 0 Other-FT Generic Survey
Other-Survey change
Key Informant Impact and Gap Feedback Tool - 2021 California Wildfires Disaster Unchanged 50 2 0 Other-
Maternal and Child Health Bureau (MCHB) Website Card Sort Unchanged 30 15 0 Other-MCHB card test script
National Hypertension Control Initiative (NHCI) Community Health Center Assessment Unchanged 350 175 0 Other-test script
OMH WEBINAR PROMISING PROGRAMS AND PRACTICES ASSESSMENTS Unchanged 1500 375 0 Other-webinar
OPA Grantee Satisfaction Survey 2023 New 222 74 0 Other-survey with instructions
Office of Population Affairs (OPA) 2021 Annual Grantee Satisfaction Survey Unchanged 173 58 0 Other-survey and instruction
Office of Population Affairs (OPA) Title X Family Planning Annual Reporting (FPAR) 2.0 Grantee Readiness Survey Unchanged 213 82 0 Other-survey and script
Office of Population Affairs (OPA) Training and Technical Assistance (T/TA) Satisfaction Survey Unchanged 2736 228 0 Other-survey and instructions
Office of Population Affairs Grantee Satisfaction Survey 2022 Unchanged 151 50 0 Other-survey with instructions
Office of the Assistant Secretary for Health (OASH) Office of Regional Health Operations (ORHO) External Customer Satisfaction Survey Unchanged 5000 250 0 Other-survey
Pre & post-program survey questions for OMH Minority Leadership Development Program New 64 365 0 Other-HHS Host-site pre-program questionnaire
Other-MLP Evaluation Scripts
Other-OMH Fellow Curriculum Post-Test Evaluations
Other-OMH Awardee Pre-Program Survey
Other-OMH Fellow Curriculum Pre-Test Evaluations
Other-OMH Fellow Pre-Program Questionnaire
TPP Network grantee technical assistance survey Unchanged 26 4 0 Other-survey and instructions
TPP Performance measures Technical Assistance Survey Unchanged 366 61 0 Other-survey script instructions and reminder emails
TPP20 Tier 1 and Tier 2 Grantee Informational Form Unchanged 75 19 0 Other-Survey
Teen Pregnancy Prevention (TPP) Evaluation Technical Assistance Product Satisfaction Feedback Survey Unchanged 494 82 0 Other-survey and instructions
Teen Pregnancy Prevention (TPP) Evaluation Technical Assistance: Satisfaction Survey for Group TA Activities Unchanged 1068 178 0 Other-survey and instructions
Tree Testing of Funding Section on HRSA.gov Unchanged 30 15 0 Instruction
Instruction
Tree Testing of HRSA's MCHB Website Unchanged 50 25 0 Instruction
Instruction
Usability Testing for HRSA.gov website properties New 200 100 0 Instruction
Instruction
User feedback for the Benefit Cliff Calculator Unchanged 400 23 0 Other-Survey
White House Conference on Food, Nutrition, Hunger, and Health listening sessions/convenings and online public comment form. Unchanged 1360 2040 0 Form and Instruction 2 Partner Led Convenings
Form and Instruction 1 White House Led Convening Tool Kit
Form and Instruction 3 Regional Led Convening Tool Kit
White House Conference on Hunger, Nutrition and Health General Public Online Conference Registration form New 1800 150 0 Form 1 WHCHNH General Public Online Viewing Registration
www.medicalcountermeasures.gov customer site feedback form Unchanged 11 3 0 Other-question
Total Burden Actually Used for Information Collections Under Currently Approved ICR: 229896 21879 0  
Total Burden Currently Requested for Information Collections Under Currently Approved ICR: 0 0 0  
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