Information Collection

Occupational Questionnaires

IC 216968 under ICR 202101-0920-008 · OMB 0920-0010.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0010 can be found here:

2025-05-01 - No material or nonsubstantive change to a currently approved collection
2024-05-07 - No material or nonsubstantive change to a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Agriculture_Screenshots_English Occupational Questionnaires	Form and Instruction
Agriculture_Screenshots_Spanish Occupational Questionnaires	Form and Instruction
Cosmetology_Screenshots_English Occupational Questionnaires	Form and Instruction
Cosmetology_Screenshots_Spanish Occupational Questionnaires	Form and Instruction
Electronic Equipment Operators_Screenshots_English Occupational Questionnaires	Form and Instruction
Electronic Equipment Operators_Screenshots_Spanish Occupational Questionnaires	Form and Instruction
Healthcare_Screenshots_English Occupational Questionnaires	Form and Instruction
Healthcare_Screenshots_Spansih Occupational Questionnaires	Form and Instruction
Occupational Questionnaires	Form and Instruction
Janitorial_Screenshots_English Occupational Questionnaires	Form and Instruction
Janitorial_Screenshots_Spanish Occupational Questionnaires	Form and Instruction
Office Worker_Screenshots_English Occupational Questionnaires	Form and Instruction
Office Worker_Screenshots_Spanish Occupational Questionnaires	Form and Instruction
Restaurant Worker_Screenshots_English Occupational Questionnaires	Form and Instruction
Restaurant Worker_Screenshots_Spanish Occupational Questionnaires	Form and Instruction
Teaching_Screenshots_English Occupational Questionnaires	Form and Instruction
Teaching_Screenshots_Spanish Occupational Questionnaires	Form and Instruction
Agriculture_Screenshots_English AttG1.1_BDSTEPS_OOQ_Agriculture.pdf	Form and Instruction
Agriculture_Screenshots_English AttG1.1_BDSTEPS_OOQ_Agriculture.pdf	Form and Instruction
Agriculture_Screenshots_Spanish AttG1.2_BDSTEPS_OOQ_Agriculture_SPAN.pdf	Form and Instruction
Agriculture_Screenshots_Spanish AttG1.2_BDSTEPS_OOQ_Agriculture_SPAN.pdf	Form and Instruction
Cosmetology_Screenshots_English AttG2.1_BDSTEPS_OOQ_Cosmetology.pdf	Form and Instruction
Cosmetology_Screenshots_English AttG2.1_BDSTEPS_OOQ_Cosmetology.pdf	Form and Instruction
Cosmetology_Screenshots_Spanish AttG2.2_BDSTEPS_OOQ_Cosmetology_SPAN.pdf	Form and Instruction
Cosmetology_Screenshots_Spanish AttG2.2_BDSTEPS_OOQ_Cosmetology_SPAN.pdf	Form and Instruction
Electronic Equipment Operators_Screenshots_English AttG3.1_BDSTEPS_OOQ_EEO.pdf	Form and Instruction
Electronic Equipment Operators_Screenshots_English AttG3.1_BDSTEPS_OOQ_EEO.pdf	Form and Instruction
Electronic Equipment Operators_Screenshots_Spanish AttG3.2_BDSTEPS_OOQ_EEO_SPAN.pdf	Form and Instruction
Electronic Equipment Operators_Screenshots_Spanish AttG3.2_BDSTEPS_OOQ_EEO_SPAN.pdf	Form and Instruction
Healthcare_Screenshots_English AttG4.1_BDSTEPS_OOQ_Healthcare.pdf	Form and Instruction
Healthcare_Screenshots_English AttG4.1_BDSTEPS_OOQ_Healthcare.pdf	Form and Instruction
Healthcare_Screenshots_Spansih AttG4.2_BDSTEPS_OOQ_Healthcare_SPAN.pdf	Form and Instruction
Healthcare_Screenshots_Spansih AttG4.2_BDSTEPS_OOQ_Healthcare_SPAN.pdf	Form and Instruction
Janitorial_Screenshots_English AttG5.1_BDSTEPS_OOQ_Janitorial.pdf	Form and Instruction
Janitorial_Screenshots_English AttG5.1_BDSTEPS_OOQ_Janitorial.pdf	Form and Instruction
Janitorial_Screenshots_Spanish AttG5.2_BDSTEPS_OOQ_Janitorial_SPAN.pdf	Form and Instruction
Janitorial_Screenshots_Spanish AttG5.2_BDSTEPS_OOQ_Janitorial_SPAN.pdf	Form and Instruction
Office Worker_Screenshots_English AttG6.1_BDSTEPS_OOQ_OfficeWorker.pdf	Form and Instruction
Office Worker_Screenshots_English AttG6.1_BDSTEPS_OOQ_OfficeWorker.pdf	Form and Instruction
Office Worker_Screenshots_Spanish AttG6.2_BDSTEPS_OOQ_OfficeWorker_SPAN.pdf	Form and Instruction
Office Worker_Screenshots_Spanish AttG6.2_BDSTEPS_OOQ_OfficeWorker_SPAN.pdf	Form and Instruction
Restaurant Worker_Screenshots_English AttG7.1_BDSTEPS_OOQ_Restaurant.pdf	Form and Instruction
Restaurant Worker_Screenshots_English AttG7.1_BDSTEPS_OOQ_Restaurant.pdf	Form and Instruction
Restaurant Worker_Screenshots_Spanish AttG7.2_BDSTEPS_OOQ_Restaurant_SPAN.pdf	Form and Instruction
Restaurant Worker_Screenshots_Spanish AttG7.2_BDSTEPS_OOQ_Restaurant_SPAN.pdf	Form and Instruction
Teaching_Screenshots_English AttG8.1_BDSTEPS_OOQ_Teaching.pdf	Form and Instruction
Teaching_Screenshots_English AttG8.1_BDSTEPS_OOQ_Teaching.pdf	Form and Instruction
Teaching_Screenshots_Spanish AttG8.2_BDSTEPS_OOQ_Teaching_SPAN.pdf	Form and Instruction
Teaching_Screenshots_Spanish AttG8.2_BDSTEPS_OOQ_Teaching_SPAN.pdf	Form and Instruction
AttG1.A1_BDSTEPS_OOQ_Agriculture-HC.pdf Agriculture Questionnaire Content_English	IC Document
AttG1.A1_BDSTEPS_OOQ_Agriculture-HC.pdf Agriculture Questionnaire Content_English	IC Document
AttG1.B2_BDSTEPS_OOQ_Agriculture_-HC_SPAN.pdf Agriculture Questionnaire Content_Spanish	IC Document
AttG1.B2_BDSTEPS_OOQ_Agriculture_-HC_SPAN.pdf Agriculture Questionnaire Content_Spanish	IC Document
AttG2.A1_BDSTEPS_OOQ_Cosmetology-HC.pdf Cosmetology Questionnaire Content_English	IC Document
AttG2.A1_BDSTEPS_OOQ_Cosmetology-HC.pdf Cosmetology Questionnaire Content_English	IC Document
AttG2.B2_BDSTEPS_OOQ_Cosmetology_-HC_SPAN.pdf Cosmetology Questionnaire Content_Spanish	IC Document
AttG2.B2_BDSTEPS_OOQ_Cosmetology_-HC_SPAN.pdf Cosmetology Questionnaire Content_Spanish	IC Document
AttG3.A1_BDSTEPS_OOQ_EEO-HC.pdf Electrical Equipment Operators Questionnaire Content_English	IC Document
AttG3.A1_BDSTEPS_OOQ_EEO-HC.pdf Electrical Equipment Operators Questionnaire Content_English	IC Document
AttG3.B2_BDSTEPS_OOQ_EEO_-HC_SPAN.pdf Electrical Equipment Operators Questionnaire Content_Spanish	IC Document
AttG3.B2_BDSTEPS_OOQ_EEO_-HC_SPAN.pdf Electrical Equipment Operators Questionnaire Content_Spanish	IC Document
AttG4.A1_BDSTEPS_OOQ_Healthcare-HC.pdf Healthcare Workers Questionnaire Content_English	IC Document
AttG4.A1_BDSTEPS_OOQ_Healthcare-HC.pdf Healthcare Workers Questionnaire Content_English	IC Document
AttG4.B2_BDSTEPS_OOQ_Healthcare_-HC_SPAN.pdf Healthcare Workers Questionnaire Content_Spanish	IC Document
AttG4.B2_BDSTEPS_OOQ_Healthcare_-HC_SPAN.pdf Healthcare Workers Questionnaire Content_Spanish	IC Document
AttG5.A1_BDSTEPS_OOQ_Janitorial-HC.pdf Janitorial Workers Questionnaire Content_English	IC Document
AttG5.A1_BDSTEPS_OOQ_Janitorial-HC.pdf Janitorial Workers Questionnaire Content_English	IC Document
AttG5.B2_BDSTEPS_OOQ_Janitorial_-HC_SPAN.pdf Janitorial Workers Questionnaire Content_Spanish	IC Document
AttG5.B2_BDSTEPS_OOQ_Janitorial_-HC_SPAN.pdf Janitorial Workers Questionnaire Content_Spanish	IC Document
AttG6.A1_BDSTEPS_OOQ_OfficeWorker-HC.pdf Office Workers Questionnaire Content_English	IC Document
AttG6.A1_BDSTEPS_OOQ_OfficeWorker-HC.pdf Office Workers Questionnaire Content_English	IC Document
AttG6.B2_BDSTEPS_OOQ_OfficeWorker_-HC_SPAN.pdf Office Workers Questionnaire Content_Spanish	IC Document
AttG6.B2_BDSTEPS_OOQ_OfficeWorker_-HC_SPAN.pdf Office Workers Questionnaire Content_Spanish	IC Document
AttG7.A1_BDSTEPS_OOQ_Restaurant-HC.pdf Restaurant Workers Questionnaire Content_English	IC Document
AttG7.A1_BDSTEPS_OOQ_Restaurant-HC.pdf Restaurant Workers Questionnaire Content_English	IC Document
AttG7.B2_BDSTEPS_OOQ_Restaurant_-HC_SPAN.pdf Restaurant Workers Questionnaire Content_Spanish	IC Document
AttG7.B2_BDSTEPS_OOQ_Restaurant_-HC_SPAN.pdf Restaurant Workers Questionnaire Content_Spanish	IC Document
AttG8.A1_BDSTEPS_OOQ_Teaching-HC.pdf Teaching Questionnaire Content_English	IC Document
AttG8.A1_BDSTEPS_OOQ_Teaching-HC.pdf Teaching Questionnaire Content_English	IC Document
AttG8.B2_BDSTEPS_OOQ_Teaching_-HC_SPAN.pdf Teaching Questionnaire Content_Spanish	IC Document
AttG8.B2_BDSTEPS_OOQ_Teaching_-HC_SPAN.pdf Teaching Questionnaire Content_Spanish	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Occupational Questionnaires

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	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
Form and Instruction	n/a	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: Epidemiologic Studies and Surveillance of Disease Problems

FR Citation: 57 FR 62812

Number of Respondents: 830

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	830	830
Annual IC Time Burden (Hours)	277	277
Annual IC Cost Burden (Dollars)	2,764	2,764

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Agriculture Questionnaire Content_English		08/26/2019
Agriculture Questionnaire Content_Spanish		08/26/2019
Cosmetology Questionnaire Content_English		08/26/2019
Cosmetology Questionnaire Content_Spanish		08/26/2019
Electrical Equipment Operators Questionnaire Content_English		08/26/2019
Electrical Equipment Operators Questionnaire Content_Spanish		08/26/2019
Healthcare Workers Questionnaire Content_English		08/26/2019
Healthcare Workers Questionnaire Content_Spanish		08/26/2019
Janitorial Workers Questionnaire Content_English		08/26/2019
Janitorial Workers Questionnaire Content_Spanish		08/26/2019
Office Workers Questionnaire Content_English		08/26/2019
Office Workers Questionnaire Content_Spanish		08/26/2019
Restaurant Workers Questionnaire Content_English		08/26/2019
Restaurant Workers Questionnaire Content_Spanish		08/26/2019
Teaching Questionnaire Content_English		08/26/2019
Teaching Questionnaire Content_Spanish		08/26/2019

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

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