Information Collection

Informing Development of CDC Content about Sexually Transmitted Diseases: Interviews with Healthcare Providers

IC 245187 under ICR 201806-0920-001 · OMB 0920-0572.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0572 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Recruitment Guide for Healthcare Professionals Informing Development of CDC Content about Sexually Transmitted Diseases: Interviews with Healthcare Providers	Form and Instruction
Moderator Guides for Interviews with Healthcare Professionals Informing Development of CDC Content about Sexually Transmitted Diseases: Interviews with Healthcare Providers	Form and Instruction
Recruitment Guide for Healthcare Professionals Attachment C2_ Recruitment Guide HCPs.docx	Form and Instruction
Moderator Guides for Interviews with Healthcare Professi Attachment D2_Moderator Guides for HCP Interviews.docx	Form and Instruction
DSTDP MSM Message Testing Part 2 (HCPs) SSA_01052021.docx Supporting Statement Part A	IC Document
DSTDP MSM Message Testing Part 2 (HCPs) SSB_01052021.docx Supporting Statement Part B	IC Document
HMTSExpeditedReviewForm_1220.pdf HMTS GENIC Submission Template	IC Document
Attachment A2_Authorizing Legislation.docx Authorizing Legislation: PHSA	IC Document
Attachment B2_Consent Forms for Healthcare Providers.docx Consent Form	IC Document
Attachment E2_MSM Messages to Test.docx Messages to be Tested	IC Document
Att F1_Project Determination Amendment 12 20.docx CDC Determination: IRB Approval Is Not Required	IC Document

IC Title:

Informing Development of CDC Content about Sexually Transmitted Diseases: Interviews with Healthcare Providers

Agency IC Tracking Number:

0920-21CE

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 and Instruction	n/a				Yes	Yes	Fillable Fileable
Form and Instruction	n/a				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 40

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 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	40	40
Annual IC Time Burden (Hours)	35	35
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement Part A		01/05/2021
Supporting Statement Part B		01/05/2021
HMTS GENIC Submission Template		01/05/2021
Authorizing Legislation: PHSA		01/05/2021
Consent Form		01/05/2021
Messages to be Tested		01/05/2021
CDC Determination: IRB Approval Is Not Required		01/05/2021

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

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