Information Collection

CDC Public Health Grand Rounds Audience Satisfaction Survey

IC 222920 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⚠️ Notice: This information collection may be referencing outdated material.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 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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.