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

View Information Collection (IC)

[2022] Online customer satisfaction survey for State and City TB Report 0920-22CE
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a State and City TB Report Partner Feedback Survey Appendix 2_Screenshots State and City TB Report Survey 02012022.docx Yes Yes Fillable Fileable
Other-WORD version of survey content to facilitate review Appendix 1_Online survey questions for state and city tb report_01252022.docx No   Paper Only

Health Public Health Monitoring

 

25 0
   
State, Local, and Tribal Governments
 
   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 25 0 25 0 0 0
Annual IC Time Burden (Hours) 6 0 6 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
GENIC Template with project description (TB Report Feedback) Generic Clearance for Qualitative Feedback_State and City TB Report_01252022.docx 02/01/2022
Notification Email Appendix 3_Notification Email_state city tb report_01252022.docx 02/01/2022
Reminder Email Appendix 4_Reminder Email_state city tb report_02012022.docx 02/01/2022
CDC Determination: IRB Approval is not Required Research Determination Customer Survey for State and City TB Report.docx 02/01/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.