Information Collection

CDC Zika Website

IC 222246 under ICR 201605-0920-001 · OMB 0920-1050.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1050 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
CDC Zika Website	Form and Instruction
CDC Zika website User Experience (UX): Questionnaire D-Questionnaire - OMB.docx	Form and Instruction
ZIKA USABILITY TEST: NOTETAKING DOCUMENT H-Usability Test Plan_Notetaking Doc.docx	Form and Instruction
A-Protocal -CDC_ZikaWeb_UX_06_24_16-OMB.docx CDC Zika Website Protocol 06SEP2016	IC Document
B-ConsentForm_Zika_UX.docx CDC Zika Website Consent Form 06SEP2016	IC Document
C-Instructions -CDCZikaUX - OMB.docx CDC Zika Website Facilitator Introduction/Instructions 06SEP2016	IC Document
E-Participant Scenarios_Men.docx CDC Zika Website Participant Scenarios - Men 06SEP2016	IC Document
F-Participant Scenarios_Women.docx CDC Zika Website Participant Scenarios - Women 06SEP2016	IC Document
G-Participant Scenarios_For specific Audiences.docx CDC Zika Website Participant Scenarios - HealthCare Providers 06SEP2016	IC Document
K - Zika Website Screenshots.docx CDC Zika Website Screenshots 06SEP2016	IC Document
List of Attachments-CDCZikaUX0616 (002).docx List of Attachments 06SEP2016	IC Document
J-fast-track-PRA-submission-short-form-cdc_zika_Usability Protocol.docx Fast Track GenIC Request	IC Document

IC Title:

CDC Zika Website

Agency IC Tracking Number:

16ATN

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA	ZIKA USABILITY TEST: NOTETAKING DOCUMENT	H-Usability Test Plan_Notetaking Doc.docx	NA	Yes	Yes	Paper Only
Form and Instruction	NA	CDC Zika website User Experience (UX): Questionnaire	D-Questionnaire - OMB.docx	NA	No		Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 50

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
CDC Zika Website Protocol 06SEP2016	A-Protocal -CDC_ZikaWeb_UX_06_24_16-OMB.docx	09/06/2016
CDC Zika Website Consent Form 06SEP2016	B-ConsentForm_Zika_UX.docx	09/06/2016
CDC Zika Website Facilitator Introduction/Instructions 06SEP2016	C-Instructions -CDCZikaUX - OMB.docx	09/06/2016
CDC Zika Website Participant Scenarios - Men 06SEP2016	E-Participant Scenarios_Men.docx	09/06/2016
CDC Zika Website Participant Scenarios - Women 06SEP2016	F-Participant Scenarios_Women.docx	09/06/2016
CDC Zika Website Participant Scenarios - HealthCare Providers 06SEP2016	G-Participant Scenarios_For specific Audiences.docx	09/06/2016
CDC Zika Website Screenshots 06SEP2016	K - Zika Website Screenshots.docx	09/06/2016
List of Attachments 06SEP2016	List of Attachments-CDCZikaUX0616 (002).docx	09/06/2016
Fast Track GenIC Request	J-fast-track-PRA-submission-short-form-cdc_zika_Usability Protocol.docx	09/08/2016

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