Testing Clear Communication Index Website

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

OMB: 0920-0956

IC ID: 210376

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0956 can be found here:

2014-02-25 - No material or nonsubstantive change to a currently approved collection

Documents and Forms

Document Name Document Type
Testing Clear Communication Index Website Form
Survey Att.K Web Survey Questions.docx Form
Att.A-Web Survey Protocol.docx A - Protocol IC Document
Att.B_1-Before-Clinicians-Flu.pdf B1 - Clinicians - before flu IC Document
Att.B_2-After-Clinicians-Flu.pdf B2 - Clinicians - after flu IC Document
Att.B_3-Before-Clinicians-Wisconsin.pdf B3 - Clinicians - before WI IC Document
Att.B_4- After-Clinicians-Wisconsin.pdf B4 - Clinicians - after WI IC Document
Att.B_5- Before-Partners-HAI.png B5 - Partners - before HAI IC Document
Att.B_6-After-Partners-HAI.pdf B6 - Partners - after HAI IC Document
Att.B_7- Before-Partners-Heart-Disease.png B7 - Partners - before HD IC Document
Att.B_8-After-Partners-Heart-Disease.pdf B8 - Partners - after HD IC Document
Att.B_9-Before-Policymakers-Budget.pdf B9 - Policy - before budget IC Document
Att.B_10-After-Policymakers-Budget.pdf B10 - Policy - after budget IC Document
Att.B_11-Before-Policymakers-Epidemiology.pdf B11 - Policy - before epi IC Document
Att.B_12- After-Policymakers-Epidemiology.pdf B12 - Policy - after epi IC Document
Att.B_13-Before-Health-Departments-MAHC.pdf B13 - HD - before MAHC IC Document
Att.B_14 -After-Health-Departments-MAHC.pdf B14 - HD - after MAHC IC Document
Att.B_15-Before-HealthDept-NVDRS_2013.12.12.pdf B15 - HD - before NVDRS IC Document
Att.B_16-After-Health-Departments-NVDRS.pdf B16 - HD - after NVDRS IC Document
Att.L Recruitment Materials.docx L - recruitment materials IC Document
GenIC_Index Web Survey.corrected.docx Request for Approval IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Testing Clear Communication Index Website	Agency IC Tracking Number:

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	Survey	Att.K Web Survey Questions.docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 264	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	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	264	0	0	0	0	0
Annual IC Time Burden (Hours)	88	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
A - Protocol	Att.A-Web Survey Protocol.docx	02/12/2014
B1 - Clinicians - before flu	Att.B_1-Before-Clinicians-Flu.pdf	02/12/2014
B2 - Clinicians - after flu	Att.B_2-After-Clinicians-Flu.pdf	02/12/2014
B3 - Clinicians - before WI	Att.B_3-Before-Clinicians-Wisconsin.pdf	02/12/2014
B4 - Clinicians - after WI	Att.B_4- After-Clinicians-Wisconsin.pdf	02/12/2014
B5 - Partners - before HAI	Att.B_5- Before-Partners-HAI.png	02/12/2014
B6 - Partners - after HAI	Att.B_6-After-Partners-HAI.pdf	02/12/2014
B7 - Partners - before HD	Att.B_7- Before-Partners-Heart-Disease.png	02/12/2014
B8 - Partners - after HD	Att.B_8-After-Partners-Heart-Disease.pdf	02/12/2014
B9 - Policy - before budget	Att.B_9-Before-Policymakers-Budget.pdf	02/12/2014
B10 - Policy - after budget	Att.B_10-After-Policymakers-Budget.pdf	02/12/2014
B11 - Policy - before epi	Att.B_11-Before-Policymakers-Epidemiology.pdf	02/12/2014
B12 - Policy - after epi	Att.B_12- After-Policymakers-Epidemiology.pdf	02/12/2014
B13 - HD - before MAHC	Att.B_13-Before-Health-Departments-MAHC.pdf	02/12/2014
B14 - HD - after MAHC	Att.B_14 -After-Health-Departments-MAHC.pdf	02/12/2014
B15 - HD - before NVDRS	Att.B_15-Before-HealthDept-NVDRS_2013.12.12.pdf	02/12/2014
B16 - HD - after NVDRS	Att.B_16-After-Health-Departments-NVDRS.pdf	02/12/2014
L - recruitment materials	Att.L Recruitment Materials.docx	02/12/2014
Request for Approval	GenIC_Index Web Survey.corrected.docx	02/12/2014

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