Office of the Associate Director for Communication (OADC) Message and Material Feedback

CDC and ATSDR Health Message Testing System

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0572 can be found here:

Documents and Forms

Document Name Document Type
Office of the Associate Director for Communication (OADC) Message and Material Feedback Form and Instruction
OADC Message and Material Feedback Survey - Screener Attachment-E_OADC Material Feedback Surveys - Screener Questions (online).docx Form and Instruction
OADC Message and Material Feedback Survey - Health Mater Attachment-I_OADC Material Feedback Surveys - Health Material Questions (online).docx Form and Instruction
Attachment-A_OADC Material Feedback Surveys Protocol.docx OADC Material Feedback Survey - Protocol IC Document
Attachment-B_OADC Material Feedback Surveys Materials.docx OADC Material Feedback Survey - Material to Test IC Document
Attachment-C_OADC Material Feedback Surveys Email Invitation.docx Email Invitation IC Document
Attachment-D_OADC Material Feedback Surveys - Screener Questions (text).docx OADC Material Feedback Survey - Screener (Text) IC Document
Attachment-F_OADC Material Feedback Surveys - Consent (text).docx OADC Material Feedback Survey - Consent (Text) IC Document
Attachment-G_OADC Material Feedback Surveys - Consent (online).docx OADC Material Feedback Survey - Consent (Online) IC Document
Attachment-H_OADC Material Feedback Surveys - Health Material Questions (text).docx OADC Material Feedback Survey - Health Material Questions (Text) IC Document
OADC TO25 Material Feedback Surveys HMTS Expedited Review Form.pdf HMTS Expedited Review Form IC Document

Information Collection (IC) Details

IC Title:	Office of the Associate Director for Communication (OADC) Message and Material Feedback	Agency IC Tracking Number:	16AQN

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 and Instruction	NA	OADC Message and Material Feedback Survey - Screener	Attachment-E_OADC Material Feedback Surveys - Screener Questions (online).docx	NA	Yes	Yes	Fillable Fileable
Form and Instruction	NA	OADC Message and Material Feedback Survey - Health Material Questions	Attachment-I_OADC Material Feedback Surveys - Health Material Questions (online).docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 240	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	240	240
Annual IC Time Burden (Hours)	21	21
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
OADC Material Feedback Survey - Protocol	Attachment-A_OADC Material Feedback Surveys Protocol.docx	06/10/2016
OADC Material Feedback Survey - Material to Test	Attachment-B_OADC Material Feedback Surveys Materials.docx	06/10/2016
Email Invitation	Attachment-C_OADC Material Feedback Surveys Email Invitation.docx	06/10/2016
OADC Material Feedback Survey - Screener (Text)	Attachment-D_OADC Material Feedback Surveys - Screener Questions (text).docx	06/10/2016
OADC Material Feedback Survey - Consent (Text)	Attachment-F_OADC Material Feedback Surveys - Consent (text).docx	06/10/2016
OADC Material Feedback Survey - Consent (Online)	Attachment-G_OADC Material Feedback Surveys - Consent (online).docx	06/10/2016
OADC Material Feedback Survey - Health Material Questions (Text)	Attachment-H_OADC Material Feedback Surveys - Health Material Questions (text).docx	06/10/2016
HMTS Expedited Review Form	OADC TO25 Material Feedback Surveys HMTS Expedited Review Form.pdf	06/10/2016

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