CDC Public Health Grand Rounds Audience Satisfaction Survey

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⚠️ Notice: This information collection may be referencing outdated material.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 0920-1050 can be found here:

Documents and Forms

Document Name Document Type
CDC Public Health Grand Rounds Audience Satisfaction Survey Form
Public Health Grand Rounds Survey OMB_Gen 1050_PHGR-Screen shots1.pdf Form
OMB_Gen1050_PHGR Audience Satisfaction Survey Application.docx Request for Approval IC Document
OMB_Gen1050_PHGR Survey Questions1.docx Survey - Word IC Document

Information Collection (IC) Details

IC Title:	CDC Public Health Grand Rounds Audience Satisfaction Survey	Agency IC Tracking Number:	16AXR

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	Public Health Grand Rounds Survey	OMB_Gen 1050_PHGR-Screen shots1.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,000	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	3,000	3,000
Annual IC Time Burden (Hours)	250	250
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Request for Approval	OMB_Gen1050_PHGR Audience Satisfaction Survey Application.docx	08/10/2016
Survey - Word	OMB_Gen1050_PHGR Survey Questions1.docx	08/10/2016

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