TA Follow-up -screenshots

Attachment 8: Technical Assistance (TA) Satisfaction Instrument-screenshots

Form Approved
OMB No. 0920-1099
Exp. Date: XX/XX/XXXX

Public reporting burden of this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions,
searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not
Public reporting burden of this collection of information is estimated to average 15 minutes per response, including the time for reviewing the instructions, searching
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
existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor,
comments
regarding
this burden
estimate
or any other
aspect of unless
this collection
of ainformation,
including
suggestions
reducing
this burden
to this
CDC/ATSDR
and a person
is not required
to respond
to a collection
of information
it displays
currently valid
OMB control
number.for
Send
comments
regarding
burden
Reports
Clifton
Road
MS D-74,
Atlanta,
Georgia 30333;
Attn: this
OMB-PRA
(0920-1099)
estimateClearance
or any otherOfficer;
aspects1600
of this
collection
of NE,
information,
including
suggestions
for reducing
burden to
CDC/ATSDR Information Collection Review Office, 1600
Clifton Rd, NE, MS D-74, Atlanta, GA 30333; ATTN: PRA (0920-New).