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Evaluation of the TravAlert Electronic Messaging System
Data Collection for Evaluation of Education, Communication, and Training Activities
OMB: 0920-0932
IC ID: 210565
OMB.report
HHS/CDC
OMB 0920-0932
ICR 201203-0920-007
IC 210565
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0932 can be found here:
2018-04-10 - Revision of a currently approved collection
2015-04-09 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Attachment 3 - TravAlert Evaluation Recruitment and Screening Tool.docx
Other-WORD
Attachment 4 - TravAlert Evaluation Tally Sheet.docx
Other-WORD
Attachment 5 - TravAlert Evaluation Participant Information Sheet.docx
Other-WORD
Attachment 6 - TravAlert Evaluation Interview Guide.docx
Other-WORD
Attachment 7 - TraveAlert Messages.docx
Other-WORD
Attachment 8 - TravAlert Evaluation Protocol.pdf
Other-WORD
TraveAlert ECT Summary Statement A - GB Edits.docx
TraveAlert ECT Summary Statement A - GB Edits
IC Document
TravAlert ECT Summary Statement B -GB edits.docx
TravAlert ECT Summary Statement B -GB edits
IC Document
Attachment 1A - Public Health Service Act (42 U.S.C. 241), Section 301.pdf
Attachment 1A - Public Health Service Act (42 U
IC Document
Attachment 1B - Public Health Service Act (42 U.S.C. 264), Section 361.pdf
Attachment 1B - Public Health Service Act (42 U
IC Document
Attachment 1D - 42 CFR part 71.pdf
Attachment 1D - 42 CFR part 71
IC Document
Attachment 1C - 42 CFR part 70.pdf
Attachment 1C - 42 CFR part 70
IC Document
Attachment 2 - 60 Day Notice- 2011-20343.pdf
Attachment 2 - 60 Day Notice- 2011-20343
IC Document
Attachment 9 - IRB Non-research Determination.pdf
Attachment 9 - IRB Non-research Determination
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Evaluation of the TravAlert Electronic Messaging System
Agency IC Tracking Number:
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
42 CFR 241
42 CFR 264
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-WORD
Attachment 3 - TravAlert Evaluation Recruitment and Screening Tool.docx
No
No
Fillable Printable
Other-WORD
Attachment 4 - TravAlert Evaluation Tally Sheet.docx
No
No
Fillable Printable
Other-WORD
Attachment 5 - TravAlert Evaluation Participant Information Sheet.docx
No
No
Fillable Printable
Other-WORD
Attachment 6 - TravAlert Evaluation Interview Guide.docx
No
No
Fillable Printable
Other-WORD
Attachment 7 - TraveAlert Messages.docx
No
No
Fillable Printable
Other-WORD
Attachment 8 - TravAlert Evaluation Protocol.pdf
No
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Immunization Management
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
600
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
600
0
0
0
0
0
Annual IC Time Burden (Hours)
35
0
0
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
TraveAlert ECT Summary Statement A - GB Edits
TraveAlert ECT Summary Statement A - GB Edits.docx
02/28/2014
TravAlert ECT Summary Statement B -GB edits
TravAlert ECT Summary Statement B -GB edits.docx
02/28/2014
Attachment 1A - Public Health Service Act (42 U
Attachment 1A - Public Health Service Act (42 U.S.C. 241), Section 301.pdf
02/28/2014
Attachment 1B - Public Health Service Act (42 U
Attachment 1B - Public Health Service Act (42 U.S.C. 264), Section 361.pdf
02/28/2014
Attachment 1D - 42 CFR part 71
Attachment 1D - 42 CFR part 71.pdf
02/28/2014
Attachment 1C - 42 CFR part 70
Attachment 1C - 42 CFR part 70.pdf
02/28/2014
Attachment 2 - 60 Day Notice- 2011-20343
Attachment 2 - 60 Day Notice- 2011-20343.pdf
02/28/2014
Attachment 9 - IRB Non-research Determination
Attachment 9 - IRB Non-research Determination.pdf
02/28/2014
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.