ICR Documents

Document Date Uploaded
SSA_07132022_updated_clean.docx 11/23/2022

Document Date Uploaded
SupportingStatementPartB full_clean.docx 11/23/2022

Title Document Document Type Date Uploaded
Authorizing Legislation: Public Health Service Act Att 1_Auth Legislation.pdf Supplementary Document 07/21/2022
60-day Federal Register Notice Att 2_60 Day OMB.pdf Supplementary Document 07/21/2022
List of Sites Att 3_List of Sites_May23.docx Supplementary Document 05/25/2023
Thank You Letter for Participants (English) Att 11_ThankYouLetter English.docx Supplementary Document 07/21/2022
Thank You Letter for Participants (Spanish) Att 12_ThankYouLetter Spanish.docx Supplementary Document 07/21/2022
CDC Determination: IRB Approval is Not Required Att 13_Research Determination.pdf Supplementary Document 07/21/2022
Privacy Impact Assessment Att 14_PIA_May23.pdf Supplementary Document 05/25/2023
Participant Information Sheet (English) Att 15_English Participant Info Sheet_May23.docx Supplementary Document 05/25/2023
Participant Information Sheet (Spanish) Att 16_Spanish Participant Info Sheet.docx Supplementary Document 07/21/2022
Participant Introductory Letter (English) Att 17_English Intro_May23.docx Supplementary Document 05/25/2023
Participant Introductory Letter (Spanish) Att 18_Spanish Intro_May23.docx Supplementary Document 05/25/2023
Survey Question Crosswalk and Background Att 19_ Survey Question Crosswalk.xlsx Supplementary Document 07/21/2022
Participant Advance Letter Att 20_Initial Letter_May23.docx Supplementary Document 05/25/2023
Participant Postcard Reminders (English and Spanish) Att 21_Postcards_May23.docx Supplementary Document 05/25/2023
References Att 22_References_updated_clean.docx Supplementary Document 11/23/2022
Thank You Letter for Participants (Somali) Att 26_ThankYouLetter Somali_May23.docx Supplementary Document 05/25/2023
Participant Information Sheet (Somali) Att 29_Somali Participant Info Sheet_May23.docx Supplementary Document 05/25/2023
Participant Introductory Letter (Somali) Att 30_Somali Intro_May23.docx Supplementary Document 05/25/2023
Participant Opt-out Postcard Att 31_Opt-out postcard_May23.docx Supplementary Document 05/25/2023
Participant Advance Letter (Massachusetts) Att 33_MA Initial Letter_May23.docx Supplementary Document 05/25/2023
Participant Introductory Letter (Massachusetts) Att 34_MA Intro_May23.docx Supplementary Document 05/25/2023
Participant Information Sheet (Massachusetts) Att 35_MA Participant Info Sheet_May23.docx Supplementary Document 05/25/2023
CHANGE REQUEST (May 2023) Minor edits to wording; additional options for mode of administration and language ICR Change request memo.docx Justification for No Material/Nonsubstantive Change 05/25/2023
Request for Nonmaterial/Non-substantive Change to an OMB Approved Information Collection ICR Change request memo_OMB 0920-1382_10.18.2023.docx Justification for No Material/Nonsubstantive Change 10/18/2023

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