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ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Assessment for the Be Antibiotics Aware (BAA) Consumer Campaign
Agency IC Tracking Number:
0920-0572-20HI
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
0920-0572
BAACS Survey FINAL PRETEST
Attachment C_BAA Consumer Survey_2020-01-22 FINAL PRETEST.docx
Yes
Yes
Fillable Printable
Form and Instruction
0920-0572
BAA Consumer Survey_FINAL POSTTEST
Attachment E_BAA Consumer Survey_2020-01-22 FINAL POSTTEST.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
180
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
180
0
180
0
0
0
Annual IC Time Burden (Hours)
45
0
45
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Att A_BAA Polot AAssessment Overview
Attachment A_BAA Pilot Assessment Overview_Consumers.docx
02/13/2020
Att B_BAA Consumer Recruitment Invitation
Attachment B_BAA Consumer Recruitment Invitation.docx
02/13/2020
Att D_BAA Consumer Survey PRESEST_Screenshots
Attachment D_BAA Consumer Survey PRETEST - Screenshots.pdf
02/13/2020
Att F_BAA Consumer Survey POSTTEST_Screenshots
Attachment F_BAA Consumer Survey POSTTEST - Screenshots.pdf
02/13/2020
AttG_BAA Consumers Exempt
Attachment G_BAA Consumers Exempt 12.10.19.pdf
02/13/2020
Att H_AU Consumer Materials for Asessment Combined_FINAL
HMTS Expedited Review Form - BAA Consumer Assessment.pdf
02/13/2020
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.