Sign-In Sheet Aid

AttE1 Sign-In Sheet Aid 20170612 clean.docx

ATSDR Communication Activities Survey (ACAS)

Sign-In Sheet Aid

OMB: 0923-0055

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ATTACHMENT E1. Sign-In Sheet Aid

ATSDR Communication Activity Survey (ACAS)

Sign-In Sheet Aid



Which stakeholder are you?

Type of Stakeholder

Potential Respondent

Community Members

  • General public

  • Community leaders

  • Faith-based leaders

  • Business leaders

Agency Stakeholders

  • State and local environmental health department employees

(ie. Environmental Health Assessors, Toxicologists, and Agency officials)



As a token of appreciation, ATSDR will mail a $5 gift card to community members after completing this survey.









File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorSmith-George, Januett P. (ATSDR/DCHI/OD)
File Modified0000-00-00
File Created2021-01-22

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