View Information Collection Request (ICR) Package
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View Information Collection (IC) List
View Supporting Statement and Other Documents
Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View Generic ICR - OIRA Conclusion
OMB Control No:
0920-1071
ICR Reference No:
201503-0920-011
Status:
Historical Active
Previous ICR Reference No:
Agency/Subagency:
HHS/CDC
Agency Tracking No:
15UK
Title:
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
Type of Information Collection:
New collection (Request for a new OMB Control Number)
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
06/22/2015
Retrieve Notice of Action (NOA)
Date Received in OIRA:
04/10/2015
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
06/30/2018
36 Months From Approved
Responses
5,800
0
0
Time Burden (Hours)
3,850
0
0
Cost Burden (Dollars)
0
0
0
Abstract:
This collection of information is necessary to enable the Agency to garner customer and stakeholder feedback in an efficient, timely manner, in accordance with our commitment to improving service delivery. The information collected from our customers and stakeholders will help ensure that users have an effective, efficient, and satisfying experience with the Agency's programs.
Authorizing Statute(s):
EO: EO 12862 Name/Subject of EO: Setting Customer Service Standards
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
79 FR 24432
04/30/2014
30-day Notice:
Federal Register Citation:
Citation Date:
80 FR 18626
04/07/2015
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
12
IC Title
Form No.
Form Name
Assessment of "The Refugee Journey to Wellbeing" Exhibit at the 2016 American Society of Tropical Medicine and Hygiene (ASTMH) Conference, Atlanta, GA
0920-17BL, 0920-17BL, 0920-17BL
Final Data Collection Instrument #1
,
Data Collection Instrument # 2
,
Final Data Collection Instrument #3 ASTHM Exhibit v3 0 smm
Assessment of Pilot CDC Zika Text Message Service
NA
CDC Zika Text Message Service Survey
Customer Satisfaction Survey for CDC AR Isolate Bank
Customer Satisfaction Survey for CDC AR Isolate Bank Year 2
none
AR Isolate Bank Survey
Customer Satisfaction Survey for Soliciting Feedback on NICE Network Nursing Infection Prevention and Control In-Person Conference Sessions
NA
NICE Network Follow-Up Survey
EDN User Assessment
none, none
EDN User Survey - screenshots
,
EDN User Survey - word
Ebola Global Migration Task Force (GMTF) Response After-Action Report (AAR) Survey
NA
2014-2015 Global Migration Task Force (GMTF) Ebola response After Action Report Survey
Formative Evaluation of CDC Autocidal Gravid Traps in Puerto Rico
NA
Focus Group Discussion Guide CDC-AGO Puerto Rico
Formative Evaluation of Zika Prevention Kits for Pregnant Women in Puerto Rico
NA
Intercept Interview of Pregnant Women in Puerto Rico
LLS Class of 2016 Laboratory Quality Survey
0920-1071
LLS Class of 2016 Laboratory Quality Survey
Mosquito Bite Prevention Kit Feedback
none, none
Mosquito Prevention Kit Feedback - English
,
Mosquito Prevention Kit Feedback - Spanish
Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) Healthcare Provider Perspective Interview
NA, NA, NA
MECFS HP - Screener
,
MECFS HP - Individual Interview
,
MECFS HP - Dyadic Interview
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
5,800
0
0
0
5,800
0
Annual Time Burden (Hours)
3,850
0
0
0
3,850
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
This is a new ICR.
Annual Cost to Federal Government:
$50,000
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Shari Steinberg 404 639-4942 sxw2@cdc.gov
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
04/10/2015
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