Mycobacterium tuberculosis: Diagnostic Principles and Procedures Course Learner Feedback Survey

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

Documents and Forms

Document Name Document Type
Form 0920-0974 Mycobacterium tuberculosis: Diagnostic Principles and Procedures Course Learner Feedback Survey Form and Instruction
0920-0974 CDC 2019 Mycobacterium tuberculosis Diagnostic Principle 04_screenshot_surveyinstrument_Mtb_course_March_2019_Learner_feedback_survey_05-06-2019.pdf Form and Instruction
02_screenshot_Mtb_course_March_2019_05-06-2019.pdf Mycobacterium tuberculosis: Diagnostic Principles and Procedures - Course Screenshot IC Document
03_screenshot_Invitation+reminders_Mtb_course_March_2019_Learner_feedback_survey_05-06-2019.pdf Mycobacterium tuberculosis Diagnostic Principles and Procedures Course Learner Feedback - Invitation and Reminder Email IC Document
01_Request_for_approval_form_Mtb_Course_March_2019_Learner_feedback_survey_05-06-2019.docx GenIC Request IC Document

Information Collection (IC) Details

IC Title:	Mycobacterium tuberculosis: Diagnostic Principles and Procedures Course Learner Feedback Survey	Agency IC Tracking Number:	0920-0974-19AWG

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	0920-0974	CDC 2019 Mycobacterium tuberculosis Diagnostic Principles and Procedures - Course Learner Feedback Survey	04_screenshot_surveyinstrument_Mtb_course_March_2019_Learner_feedback_survey_05-06-2019.pdf	NA	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 25	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	25	25
Annual IC Time Burden (Hours)	2	2
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Mycobacterium tuberculosis: Diagnostic Principles and Procedures - Course Screenshot	02_screenshot_Mtb_course_March_2019_05-06-2019.pdf	06/10/2019
Mycobacterium tuberculosis Diagnostic Principles and Procedures Course Learner Feedback - Invitation and Reminder Email	03_screenshot_Invitation+reminders_Mtb_course_March_2019_Learner_feedback_survey_05-06-2019.pdf	06/10/2019
GenIC Request	01_Request_for_approval_form_Mtb_Course_March_2019_Learner_feedback_survey_05-06-2019.docx	06/10/2019

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