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

View Information Collection (IC)

[NCZEID] Lyme Disease Creative and Message Testing Focus Groups 0920-25-0124
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0920-25-0124 Lyme Disease Screener Attachment 1_WS-NCEZID_Lyme Disease FG Screener.docx Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

768 0
   
Individuals or Households
 
   0 %

  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 768 0 768 0 0 0
Annual IC Time Burden (Hours) 154 0 154 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Consent Form Attachment 2_WS-NCEZID_Lyme Disease FG Consent Form.docx 06/03/2025
Guide Attachment 3_WS-NCEZID_Lyme Disease FG Guide.docx 06/03/2025
Determination Attachment 4_Human Subjects Determination Memo.pdf 06/03/2025
Concept and Message Testing Stimuli Attachment 5_Concept and Message Testing Stimuli.pdf 06/03/2025
GenIC Request WS-NCEZID_Lyme Disease_GenIC Request Form.docx 06/03/2025
SSA WS-NCEZID_Lyme Disease_OMB Supporting Statement A.docx 06/03/2025
SSB WS-NCEZID_Lyme Disease_OMB Supporting Statement B.docx 06/03/2025
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.