Information Collection

CDC Social Media Satisfaction Survey

IC 212040 under ICR 201402-0920-015 · OMB 0920-0956.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
SMsurveyQuestions-Spring2014-OMB.docx	Other-WORD
SMsurvey_ScreenCaptures_Spring2014.docx	Other-Screenshots
Survey1template _SocialMediaSat-May2014.docx Request for Approval	IC Document

IC Title:

Agency IC Tracking Number:

14AHQ

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-WORD			SMsurveyQuestions-Spring2014-OMB.docx		Yes	Yes	Fillable Printable
Other-Screenshots			SMsurvey_ScreenCaptures_Spring2014.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

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: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	600	600
Annual IC Time Burden (Hours)	80	80
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Request for Approval	Survey1template _SocialMediaSat-May2014.docx	06/24/2014

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