View Information Collection Request (ICR) Package
Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
This script is used to control the display of information in this page.
Display additional information by clicking on the following:
All
Brief and OIRA conclusion
Abstract/Justification
Legal Statutes
Rulemaking
FR Notices/Comments
IC List
Burden
Misc.
Common Form Info.
Certification
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:
0920-1050
ICR Reference No:
201605-0920-001
Status:
Historical Active
Previous ICR Reference No:
201411-0920-012
Agency/Subagency:
HHS/CDC
Agency Tracking No:
Title:
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
06/09/2016
Retrieve Notice of Action (NOA)
Date Received in OIRA:
05/10/2016
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
06/30/2019
36 Months From Approved
02/28/2018
Responses
206,400
0
17,400
Time Burden (Hours)
60,750
0
11,550
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. Revision request to add respondents and burden.
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:
81 FR 27134
05/05/2016
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
47
IC Title
Form No.
Form Name
2016 Science Ambassador Workshop Satisfaction Survey
NA
2016 Science Ambassador Workshop Satisfaction Survey
2017 Science Ambassador Fellowship Summer Course Satisfaction Survey
0920-17ANW, 0920-17ANW
Att_1_0920-1050_2017_Science_Amb_Fwshp_Sum_Course_Cust_Sat_Survey_Subm
,
Att_2_0920-1050_2017_Science_Amb_Fwshp_Sum_Course_Cust_Sat_Survey_Screen...
2018 CUPS/Ferguson Summer Showcase
none, none, none
Session 2 survey
,
Session 1 survey
,
Session 3 survey
2018 Federal Select Agents Program Inspection Feedback Survey
0920-1050
2019 Federal Select Agent Program Inspection Feedback Survey
2018 ITSO Customer Satisfaction Survey
none
2018 ITSO Customer Satisfaction Survey
2018 Public Health Ethics Forum
0920-1050
PHE Forum Survey
2018 Science Ambassador Fellowship Exit Satisfaction Survey
0920-1050
Science Ambassador Fellowship Exit Satisfaction Survey - Screenshot
2018 Science Ambassador Fellowship Summer Course Satisfaction Survey
n/a
2018 Science Ambassador Fellowship Summer Course Satisfaction Survey
2019 Science Ambassador Fellowship Regional Training Workshop Customer Satisfaction Survey
0920-1050
Science Ambassador Regional Training Workshop Satisfaction Survey
APIH Fellowship Program Orientation Survey
0920-1050, 0920-1050
APIH - ASPPH ORIENTATION SURVY
,
APIH - AACN ORIENTATON SURVEY
Academic Partnerships to Improve Health (APIH) Program Training/Workshop Feedback Survey (January – June, 2019)
n/a
APIH Training Feedback Survey
Adapting Clnical Guidelines for the Digital Age Meeting Assessment
none
Assessment
Assessing Customer Satisfaction with Health, US Report
CDC DataViz Day Needs Assessment
0920-1050
DataViz Day Needs Assessment
CDC Fellowships, Internships, and Learning Opportunities GovDelivery Newsletter Customer Satisfaction Survey
0920-1050
Customer Satisfaction Survey: CDC Fellowships, Internships, and Learning Opportunities GovDelivery (GovD) Newsletter - Screenshot
CDC Latent Tuberculosis Infection Mobile App Survey
0920-17AUP, 0920-17AUP, 0920-17AUP
Attachment A_LTBI Mobile App Survey Questions
,
Attachment B_LTBI Mobile App Survey_Current Users_Screenshots
,
Attachment C_LTBI Mobile App Survey_Potential Users_Screenshots
CDC Learning Connection Gov D Newsletter Survey
0920-1050
GOV.D Survey Questions
CDC Page Info Tab
0920-1050
CUSTOMER SATISFACTION SURVEY: CDC’S PAGE INFO TAB
CDC Public Health Emergency Management Fellowship Feedback
0920-1050
PHEMF Feedback
CDC Public Health Grand Rounds Audience Satisfaction Survey
none
Public Health Grand Rounds Survey
CDC Solve the Outbreak Mobile App
N/A, N/A, N/A
Solve the Outbreak (General Public version)
,
Solve the Outbreak (Teacher version)
,
Solve the Outbreak (Student version)
CDC Template Navigation
CDC Zika Website
NA, NA
CDC Zika website User Experience (UX): Questionnaire
,
ZIKA USABILITY TEST: NOTETAKING DOCUMENT
CDC-INFO Email Survey
none
CDC-INFO Email Survey
CDC-INFO Interactive Voice Response Survey
0920-1050
17FZ
Customer Feedback on CDC CVD Policy Platform
Customer Satisfaction Survey for 5 CDC Laboratories Seeking ISO 17025 Accreditation for Laboratory Quality
N/A, N/A
CDC Laboratory Cusomter Satisfaction Survey (paper version)
,
CDC Laboratory Customer Satisfaction Survey (web version)
Customer Service Feedback Survey of 2017 EIS Conference
NA
2017 EIS Conference Customer Service Feedback Survey - Screenshot
Customer Service Feedback Survey of 2018 EIS Conference
0920-1050
EIS Conference Customer Service Feedback Survey - Screenshots
Disaster Response Training Needs Assessment
0920-1050
Needs Assessment
Education and Training Services Branch Customer Satisfaction Survey
none
Customer Satisfaction Survey
Emergency Partners Information Connection (EPIC) Partner Interaction
FLU Vaccines Section Usability Testing
Feedback for 2018 Place & Health Conference
0920-1050
Feedback for 2018 Place & Health Conference
ITSO Customer Satisfaction Survey
NA, NA
2017 ITSO Customer Satisfaction Survey - Domestic
,
2017 ITSO Customer Satisfaction Survey - Global
MosquitoNet Surveillance System Focus Group
0920-1050
MosquitoNET Focus Group Discussion Guide
National Diabetes Prevention Program Customer Service Center (National DPP CSC) -- Customer Satisfactory Surveys
0920-1050
National DDP Customer Service Center -- Surveys Along the Customer Journey
Office of Scientific Integrity Customer Satisfaction Survey
none
Customer Satisfaction Survey
Participant Assessment of Science Integrity Branch Trainings
none
Training Assessment
Partner Feedback Assessment Of Sexually Transmitted Disease (STD) Clinic Processes For Conducting And Documenting Routine HIV Testing
NA, NA
DSTDP Assessment: HIV testing in SSuN STD Clinics - STD Clinic Provider Interview Guide
,
DSTDP Assessment: HIV testing in SSuN STD Clinics - STD Clinic/Data Manager Interview Guide
Post-Meeting Survey of Attendees at the 2018 Childhood Lead Poisoning Prevention Annual Cooperative Agreement Recipient's Meeting
0920-1050
0920-1050
Seasonal Flu: Email Updates Satisfaction Survey
NA
Flu Email Updates Survey
Special Emphasis Panel (SEP) Peer Review Evaluation
17WN
Att 1. Instrument_Peer Reviewers' Evaluation Form 3.2.17
TB Training and Education Needs Assessment of the US-affiliated Pacific Islands and Hawaii
none, none
TB Survey - word
,
TB Survey - screenshots
Technical Packages for Violence Prevention Using Evidence-based Strategies in Your Violence Prevention Efforts Online Survey
none
Technical Package Violence Prevention Survey
Understanding the Use of CDC Resources and Tools during 2017 Hurricane Disaster Response
Web Usability Study for CDC's Radiation Emergencies Website
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
206,400
17,400
0
189,000
0
0
Annual Time Burden (Hours)
60,750
11,550
0
49,200
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
Burden increase due to anticipating additional collections to absorb discontinuing clearances (0920-1003 and 0920-0998).
Annual Cost to Federal Government:
$55,000
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:
05/10/2016