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Assessment for the Get Ahead of Sepsis Consumer Campaign 0920-0572-20HL
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-0572 GAOS Consumer Survey Pre-test HMTS Attachment D_GAOS Consumer Survey PRE-TEST HMTS.pdf Yes Yes Fillable Fileable
Form and Instruction 0920-0572 GAOS Consumer Survey Post-test HMTS Attachment F_GAOS Consumer Survey POST-TEST HMTS.pdf Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

360 0
   
Individuals or Households
 
   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 360 0 360 0 0 0
Annual IC Time Burden (Hours) 90 0 90 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
GAOS Overview Consumers Attachment A_GAOS Pilot Assessment Overview_Consumers.docx 02/26/2020
Consumer Recruitment Invitation Attachment B_GAOS Consumer Recruitment Invitation final.docx 02/26/2020
Pretest Instrument Word version Attachment C_GAOS Consumer Survey_1.24.20_FINAL PRETEST.docx 02/26/2020
Posttest Instrument Word version Attachment E_GAOS Consumer Survey_1.24.20_FINAL POSTTEST.docx 02/26/2020
Human Subjects Determination Attachment G_GAOS Consumer and HCP Exempt 12.20.19.pdf 02/26/2020
GAOS Consumer Materials for Assessment Attachment H_GAOS Consumer Materials for 2020 Assessment FINAL.pdf 02/26/2020
HMTS Expedited Review Form GAOS HMTS Expedited Review Form - GAOS Consumer Assessment final.pdf 02/26/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.