CDC/ATSDR Needs Assessment of GIS use in Public Health Emergencies

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0923-0047 can be found here:

Documents and Forms

Document Name Document Type
Form 0923-17AZF CDC/ATSDR Needs Assessment of GIS use in Public Health Emergencies Form and Instruction
0923-17AZF Attachment B GPHEW NA Survey Text Attachment B GPHEW NA Survey Text.docx Form and Instruction
0923-17AZF Attachment C GPHEW NA Survey Screenshots Attachment C GPHEW NA Survey Screenshots.docx Form
Attachment A Recruitment Emails for GPHEW Needs Assessment.docx Attachment A Recruitment Emails for GPHEW Needs Assessment IC Document
Request for Approval_GPHEW Needs Assessment Survey_.pdf Request for Approval_GPHEW Needs Assessment Survey_ IC Document

Information Collection (IC) Details

IC Title:	CDC/ATSDR Needs Assessment of GIS use in Public Health Emergencies	Agency IC Tracking Number:	0923-17AZF

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	0923-17AZF	Attachment B GPHEW NA Survey Text	Attachment B GPHEW NA Survey Text.docx		Yes	Yes	Fillable Fileable
Form	0923-17AZF	Attachment C GPHEW NA Survey Screenshots	Attachment C GPHEW NA Survey Screenshots.docx		Yes	Yes	Fillable Printable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	13	13
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment A Recruitment Emails for GPHEW Needs Assessment	Attachment A Recruitment Emails for GPHEW Needs Assessment.docx	08/22/2017
Request for Approval_GPHEW Needs Assessment Survey_	Request for Approval_GPHEW Needs Assessment Survey_.pdf	08/23/2017

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