National Health Security Preparedness Index Assessment

Attachment B: Online Assessment Instrument Web Version

Form Approved

OMB No. 0920-0879

Expiration Date 01/31/2021

CDC NATIONAL HEALTH SECURITY PREPAREDNESS INDEX

ONLINE ASSESSMENT INSTRUMENT, WEB VERSION

Prepared For:

U.S. Centers for Disease Control and Prevention

Contract # 75D30118C03568 00001

Utility of the National Health Security Preparedness Index for Public Health Preparedness

Prepared by:

University of Kentucky

University of Colorado

University of California-Los Angeles

New York University

Version Date:

May 15, 2020

CDC estimates the average public reporting burden for this collection of information as 52 minutes per response, including the time for reviewing instructions, searching existing data/information sources, gathering and maintaining the data/information needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0879).