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Federal forms, ICRs, and supporting documents

Information Collection

Message Testing for CDCs Division of Community Health with the General Public, Engaged Public, and Community Leaders

IC 204153 under ICR 201501-0920-003 · OMB 0920-0572.

Documents and Forms
Document Name
Document Type
Form and Instruction
Instruction
Instruction
Instruction
Instruction
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Message Testing for CDCs Division of Community Health with the General Public, Engaged Public, and Community Leaders
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-0572 Moderators Guide- Engaged Public Triad Moderators Guide- Engaged Public Triad.docx Yes Yes Fillable Printable
Instruction DCH Screener- General Public FG Engaged Public Triad.docx Yes Yes Printable Only
Form and Instruction 0920-0572 Moderators Guide- Community Leaders Triad Moderators Guide- Community Leaders Triad.docx Yes Yes Printable Only
Form and Instruction 0920-0572 Moderators Guide- General Public FG Moderators Guide- General Public FG.docx Yes Yes Fillable Printable
Instruction Consent form- Community Leaders Triad.docx Yes Yes Printable Only
Instruction Consent form- Engaged Public Triad.docx Yes Yes Printable Only
Instruction Consent form- General Public FG.docx Yes Yes Printable Only

Health Public Health Monitoring

 

336 0
   
Individuals or Households
 
   0 %

  Requested 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 336 0 0 0 0 336
Annual IC Time Burden (Hours) 492 0 0 0 0 492
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
DCH Message Testing Supplement DCH Message Testing Supplement.docx 09/14/2012
Burden table by audience and activity Burden table by audience and activity.docx 09/14/2012
Overview of Recruitment Process for Community Leaders Overview of Recruitment Process for Community Leaders.docx 09/14/2012
HMTS Expedited Review Form 090412 HMTS Expedited Review Form 090412.pdf 09/18/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.