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View Information Collection (IC)

Pilot Evaluation for Cervical Cancer Clinical Decision Support Tools 0920-1050-22IK
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1050 Usability Testing Script for CCSM CDS Interface CCSM Usability Script - Attachment B Usability Script.docx No   Paper Only

Health Public Health Monitoring

 

45 0
   
Private Sector Businesses or other for-profits
 
   50 %

  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 45 0 45 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

Title Document Date Uploaded
Usability Evaluation and Analysis Overview for CCSM CDS Interface CCSM CDS Usability Testing Overview - Attachment A Instructions.docx 08/25/2022
Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0920-1050) Customer Service GenIC Clearance Template (Final 5.3) for Cervical Cancer CDS Usability Evaluation .docx 08/25/2022
Participant Information Sheet for CCSM CDS Interface CCSM Usability Testing - Attachment C Participant Info.docx 08/29/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.