Domestic Readiness Initiative on Zika Virus Disease - Year 2 Core Campaign Materials

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⚠️ Notice: This information collection may be referencing outdated material.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
Domestic Readiness Initiative on Zika Virus Disease - Year 2 Core Campaign Materials Form and Instruction
Focus Group Screener Attachment_1_Screener for Focus Groups.docx Form and Instruction
Focus Group Guide Attachment 2_Focus Group Guide.docx Form and Instruction
HMTS Expedited Review Form_Zika Readiness Initiative Campaign_Year 2 Core Campaign Materials Testing.pdf HMTS Expedited Review Form IC Document
Attachment 3_Concepts for Testing_US PR_2 Concepts.pptx Concepts (2) for Testing US/PR IC Document

Information Collection (IC) Details

IC Title:	Domestic Readiness Initiative on Zika Virus Disease - Year 2 Core Campaign Materials	Agency IC Tracking Number:	0920-0572-17AGK

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	Focus Group Screener	Attachment_1_Screener for Focus Groups.docx	NA	No		Paper Only
Form and Instruction	NA	Focus Group Guide	Attachment 2_Focus Group Guide.docx	NA	No		Paper Only

Line of Business: Disaster Management

Subfunction: Emergency Response

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 150	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	150	150
Annual IC Time Burden (Hours)	81	81
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
HMTS Expedited Review Form	HMTS Expedited Review Form_Zika Readiness Initiative Campaign_Year 2 Core Campaign Materials Testing.pdf	04/21/2017
Concepts (2) for Testing US/PR	Attachment 3_Concepts for Testing_US PR_2 Concepts.pptx	04/26/2017

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