Bring Your Brave Campaign Message Testing

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⚠️ Notice: This information collection may be referencing outdated material.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
Bring Your Brave Campaign Message Testing Form
Bring Your Brave Campaign Testing Survey Attachment_B_Online_Survey_3.15.17 (003).docx Form
HMTS_Expedited_Review_Form_1.5.17.docx Request for Approval IC Document
Attachment_C_Materials_for_testing.pptx Materials for Testing IC Document
Attachment_D_684_Form.pdf Non-research Determination IC Document
Attachment_A_Protocol_Summary_3.15.17.docx Protocol Summary IC Document

Information Collection (IC) Details

IC Title:	Bring Your Brave Campaign Message Testing	Agency IC Tracking Number:	17TN

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	Bring Your Brave Campaign Testing Survey	Attachment_B_Online_Survey_3.15.17 (003).docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	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	200	200
Annual IC Time Burden (Hours)	67	67
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Request for Approval	HMTS_Expedited_Review_Form_1.5.17.docx	03/13/2017
Materials for Testing	Attachment_C_Materials_for_testing.pptx	03/13/2017
Non-research Determination	Attachment_D_684_Form.pdf	03/13/2017
Protocol Summary	Attachment_A_Protocol_Summary_3.15.17.docx	03/16/2017

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