Information Collection

Testing of Sample Materials Developed Using the CDC Clear Communications Index

IC 209487 under ICR 201402-0920-015 · OMB 0920-0956.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Testing of Sample Materials Developed Using the CDC Clear Communications Index	Form and Instruction
Attachment 3: Flu Vaccine Information for Health Care Wo Attachment3_Clinicians_Influenza_2013.10.31.docx	Form and Instruction
Attachment 4: Autism and Developmental Disabilities Moni Attachment4_Clinicians_Wisconsin-Surveillance-of-Autism_2013.10.31.docx	Form and Instruction
Attachment 5: HAI Summary Data Reports: Questions and An Attachment5_CDC-Partners_Healthcare-Associated-Infections_2013.10.31.docx	Form and Instruction
Attachment 6: Heart Disease Facts Attachment6_CDC-Partners_Heart-Disease-Fact-Sheet_2103.10.31.docx	Form and Instruction
Attachment 7: Use the Model Aquatic Health Code to Make Attachment7_Public-Health-Department-Staff_Model-Aquatic-Health-Code_2013.10.31.docx	Form and Instruction
Attachment 8: The National Violent Death Reporting Syste Attachment8_Public-Health-Department-Staff_National-Violent-Death-Reporting-System_2013.10.31.docx	Form and Instruction
Attachment 9: CDC Priorities and FY 2014 Budget Request Attachment9_Policymakers_CDC-Budget-Overview_2013.10.31.docx	Form and Instruction
Attachment 10: CDC Keeps America Healthy, Safe, and Secu Attachment10_Policymakers_Introduction-to-Epidemiology_2013.10.31.docx	Form and Instruction
Attachment 2: Click Testing Screen Shots Attachment-2-verify-screenshots_2013.11.19_LOW[smallpdf.com].zip	Form and Instruction
GenIC_Index Click Test 2013.11.06.docx GenIC_Index Click Test 2013	IC Document
List of Attachments for Testing of Sample Materials Developed Using the CDC Clear Communications Index.docx List of Attachments for Testing of Sample Materials Developed Using the CDC Clear Communications Index	IC Document
Attachment1_CDC-Index-Click-testing-Protocol_2013.11.07.docx Attachment1_CDC-Index-Click-testing-Protocol_2013	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Testing of Sample Materials Developed Using the CDC Clear Communications Index

Agency IC Tracking Number:

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	None	Attachment 3: Flu Vaccine Information for Health Care Workers	Attachment3_Clinicians_Influenza_2013.10.31.docx	Yes	Yes	Fillable Printable
Form and Instruction	None	Attachment 4: Autism and Developmental Disabilities Monitoring Network (ADDM) Tracking Autism in Wisconsin: What You Need to Know	Attachment4_Clinicians_Wisconsin-Surveillance-of-Autism_2013.10.31.docx	Yes	Yes	Fillable Printable
Form and Instruction	None	Attachment 5: HAI Summary Data Reports: Questions and Answers	Attachment5_CDC-Partners_Healthcare-Associated-Infections_2013.10.31.docx	Yes	Yes	Fillable Printable
Form and Instruction	None	Attachment 6: Heart Disease Facts	Attachment6_CDC-Partners_Heart-Disease-Fact-Sheet_2103.10.31.docx	Yes	Yes	Fillable Printable
Form and Instruction	None	Attachment 7: Use the Model Aquatic Health Code to Make Swimming Healthy and Safe	Attachment7_Public-Health-Department-Staff_Model-Aquatic-Health-Code_2013.10.31.docx	Yes	Yes	Fillable Printable
Form and Instruction	None	Attachment 8: The National Violent Death Reporting System (NVDRS): A Valuable Tool for Prevention	Attachment8_Public-Health-Department-Staff_National-Violent-Death-Reporting-System_2013.10.31.docx	Yes	Yes	Fillable Printable
Form and Instruction	None	Attachment 9: CDC Priorities and FY 2014 Budget Request	Attachment9_Policymakers_CDC-Budget-Overview_2013.10.31.docx	Yes	Yes	Fillable Printable
Form and Instruction	None	Attachment 10: CDC Keeps America Healthy, Safe, and Secure. Case Study: Fort Leonard Wood, Missouri	Attachment10_Policymakers_Introduction-to-Epidemiology_2013.10.31.docx	Yes	Yes	Fillable Printable
Form and Instruction	None	Attachment 2: Click Testing Screen Shots	Attachment-2-verify-screenshots_2013.11.19_LOW[smallpdf.com].zip	Yes	Yes	Printable Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 32

Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	32	32
Annual IC Time Burden (Hours)	11	11
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
GenIC_Index Click Test 2013	GenIC_Index Click Test 2013.11.06.docx	11/20/2013
List of Attachments for Testing of Sample Materials Developed Using the CDC Clear Communications Index	List of Attachments for Testing of Sample Materials Developed Using the CDC Clear Communications Index.docx	11/20/2013
Attachment1_CDC-Index-Click-testing-Protocol_2013	Attachment1_CDC-Index-Click-testing-Protocol_2013.11.07.docx	11/20/2013

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