Adult Targeted Surveillance Survey

Targeted Surveillance and Biometric Studies for Enhanced Evaluation of CTGs

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0977 can be found here:

Documents and Forms

Document Name Document Type
Adult Targeted Surveillance Survey Form
Adult Targeted Survey Att 8A_ATSS Instrument.doc Form
Spanish Adult Targeted Survey Att S8A_ATSS Spanish.docx Form
Att 8B_ATSS_FAQGuide.docx ATTS Guide IC Document
Att S8B_ATSS FAQGuide Spanish.doc Spanish ATTS Guide IC Document

Information Collection (IC) Details

IC Title:	Adult Targeted Surveillance Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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	none	Adult Targeted Survey	Att 8A_ATSS Instrument.doc		Yes	Yes	Fillable Fileable
Form	none	Spanish Adult Targeted Survey	Att S8A_ATSS Spanish.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title: Epidemiologic Studies and Surveillance of Disease Problems	FR Citation: 57 FR 62812

Number of Respondents: 11,300	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 55 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	11,300	11,300
Annual IC Time Burden (Hours)	5,273	5,273
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
ATTS Guide	Att 8B_ATSS_FAQGuide.docx	08/07/2012
Spanish ATTS Guide	Att S8B_ATSS FAQGuide Spanish.doc	08/07/2012

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.