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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
[NCZEID] Focus Groups and Interviews with Consumers and HCPs on Alpha-Gal Syndrome
Agency IC Tracking Number:
0920-1154-24CA
IC Status:
Unchanged
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
0920-24CA
Attachment 1 - CDC DVBD - AGS Data Collection - Focus Group Screener - 12.14.23
Attachment 1 - CDC DVBD - AGS Data Collection - Focus Group Screener - 12.14.23.docx
Yes
Yes
Fillable Fileable
Form and Instruction
0920-24CA
Attachment 5 - CDC DVBD - AGS Data Collection - Focus Group Discussion Guide - 12.14.23
Attachment 5 - CDC DVBD - AGS Data Collection - Focus Group Discussion Guide - 12.14.23.docx
Yes
Yes
Fillable Fileable
Form and Instruction
0920-24CA
Attachment 2 - CDC DVBD - AGS Data Collection - Interview Screener - 12.14.23
Attachment 2 - CDC DVBD - AGS Data Collection - Interview Screener - 12.14.23.docx
Yes
Yes
Fillable Fileable
Form and Instruction
0920-24CA
Attachment 6 - CDC DVBD - AGS Data Collection - Interview Discussion Guide - 12.14.23
Attachment 6 - CDC DVBD - AGS Data Collection - Interview Discussion Guide - 12.14.23.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Training and Employment
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
451
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Requested
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
451
0
0
0
0
451
Annual IC Time Burden (Hours)
93
0
0
0
0
93
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Attachment 4 - CDC DVBD - AGS Data Collection - Interview Consent Form - 12.14.23
Attachment 4 - CDC DVBD - AGS Data Collection - Interview Consent Form - 12.14.23.docx
01/22/2024
Attachment 7 - CDC DVBD - AGS Data Collection - Draft Message Stimuli - 12.14.23
Attachment 7 - CDC DVBD - AGS Data Collection - Draft Message Stimuli - 12.14.23.docx
01/22/2024
Attachment 8- Human Subjects Determination
Attachment 8- Human Subjects Determination.pdf
01/22/2024
GenIC Submission Form - CDC DVBD - AGS Data Collection - 1.8.24
GenIC Submission Form - CDC DVBD - AGS Data Collection - 1.8.24.docx
01/22/2024
Supporting Statement A - CDC DVBD - AGS Data Collection - 12.14.23
Supporting Statement A - CDC DVBD - AGS Data Collection - 12.14.23.docx
01/22/2024
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.