View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Customer Service Satisfaction Assessment of Public Health Laboratory Tuberculosis Laboratory Site Visits conducted by CDC DTBE Laboratory Consultants- Online Survey	Agency IC Tracking Number:	0920-1027-22IT

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	0920-1027	Site Visit Evaluation - REDCap	SiteVisitEvaluation_CDCDTBELBL_RedCap 8.30.22.pdf	NA	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 58	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	58	0	58	0	0	0
Annual IC Time Burden (Hours)	10	0	10	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
0920-1027 - GenIC Request Memo	Customer Service GenIC Clearance Template.docx	09/09/2022
NOA from approved GenIC (2020)	NOA_1027-20ED.pdf	09/09/2022

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.