View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Shigella Hypothesis Generating Questionnaire 0920-1307
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1307 SHIGELLA HYPOTHESIS GENERATING QUESTIONNAIRE (English version) Att C1 SHGQ_(Health Department) Phone Interview (English).docx Yes Yes Fillable Fileable
Form and Instruction 0920-1307 SHIGELLA HYPOTHESIS GENERATING QUESTIONNAIRE (Spanish version) Phone Interview Att C2. SHGQ (Health Department) Phone Interview_(Spanish version).docx Yes Yes Fillable Fileable
Form and Instruction 0920-1307 SHIGELLA HYPOTHESIS GENERATING QUESTIONNAIRE_Self-administered Web Survey (English) Att C4 SHGQ_English_Web v2.pdf Yes Yes Fillable Fileable
Form and Instruction 0920-1307 CUESTIONARIO SOBRE LA SHIGELLA PARA LA GENERACIÓN DE HIPÓTESIS (Spanish version) Phone Interview Att C3 SHGQ_Spanish_Web v2.pdf Yes Yes Fillable Fileable

Health Public Health Monitoring

 

1,500 0
   
Individuals or Households
 
   90 %

  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 1,500 0 0 0 0 1,500
Annual IC Time Burden (Hours) 1,125 0 0 0 0 1,125
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Att F1 SHGO by Mode of Collections (Englsih) Att F1 English SHGQ by Mode of collection_FINAL1.docx 10/06/2023
Att F2 SHGO by Mode of Collection (Spanish) Att F2 Spanish SHGQ by Mode of collection_FINAL1.docx 10/06/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.