Information Collection Request

Federal COVID Response - Audience Feedback to Inform Ongoing Messaging and Strategies for "Combat COVID" (OD)

ICR 202111-0925-001 · OMB 0925-0769 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 6 Custom Web Survey with Consumer and Provider Paths Form Modified Available
Form 6 Benchmark & Follow-Up Web Survey – HCP Audience Form Modified Repair queued
Form 6 Custom Web Survey with Consumer and Provider Paths Form Modified Available
Form 6 Benchmark & Follow-Up Web Surveys – Consumer Audience Form Modified Repair queued
Form 5 Audience Feedback Team Sample Online Bulletin Board Prompt Form and Instruction Unchanged Repair queued
Form 4 Moderators Guide for Discussion with HCPs Form and Instruction Unchanged Available
Form 4 HCP Audience Feedback Activity Form and Instruction Unchanged Repair queued
Form 5 Audience Feedback Team Sample Online Bulletin Board Prompt Form and Instruction Unchanged Available
Form 3 Moderators Guide for Discussion with Consumers Form and Instruction Unchanged Available
Form 3 Consumer Audience Feedback Activity Form and Instruction Unchanged Repair queued
Form 2 HCP Recruitment Screener Form and Instruction Unchanged Available
Form 2 HCP Audience Feedback Team Screener Form and Instruction Unchanged Repair queued
Form 1 Consumer Recruitment Screener Form and Instruction Unchanged Available
Form 1 Consumer Audience Feedback Team Screener Form and Instruction Unchanged Repair queued
Updated Attachment 6 - Custom Web Survey with Consumer and Provider Paths track changes 110821.docx Supplementary Document Uploaded 2021-11-09 Repair queued
FCR Non-Substantive Change Request Memo_0925-0769_Nov2021.docx Justification for No Material/Nonsubstantive Change Uploaded 2021-11-09 Repair queued
Supporting Statement for Fed COVID Resp Audience Feedback - 061721v2.docx Supporting Statement A Uploaded 2021-06-17 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
247689 Benchmark & Follow-Up Web Survey – HCP Audience Form ModifiedCustom Web Survey with Consumer and Provider Paths
247689 Benchmark & Follow-Up Web Survey – HCP Audience Form Modified
247688 Benchmark & Follow-Up Web Surveys – Consumer Audience Form ModifiedCustom Web Survey with Consumer and Provider Paths
247688 Benchmark & Follow-Up Web Surveys – Consumer Audience Form Modified
247687 HCP Audience Feedback Activity Form and Instruction UnchangedAudience Feedback Team Sample Online Bulletin Board Prompt
247687 HCP Audience Feedback Activity Form and Instruction UnchangedModerators Guide for Discussion with HCPs
247687 HCP Audience Feedback Activity Form and Instruction Unchanged
247686 Consumer Audience Feedback Activity Form and Instruction UnchangedAudience Feedback Team Sample Online Bulletin Board Prompt
247686 Consumer Audience Feedback Activity Form and Instruction UnchangedModerators Guide for Discussion with Consumers
247686 Consumer Audience Feedback Activity Form and Instruction Unchanged
247685 HCP Audience Feedback Team Screener Form and Instruction UnchangedHCP Recruitment Screener
247685 HCP Audience Feedback Team Screener Form and Instruction Unchanged
247684 Consumer Audience Feedback Team Screener Form and Instruction UnchangedConsumer Recruitment Screener
247684 Consumer Audience Feedback Team Screener Form and Instruction Unchanged

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
12/31/2021 12/31/2021 12/31/2021
12,300 0 12,300
3,528 0 3,528
0 0 0





Reginfo record details
6
table that charts list of burden
IC Title Form No. Form Name
Benchmark & Follow-Up Web Survey – HCP Audience 6
Benchmark & Follow-Up Web Surveys – Consumer Audience 6
Consumer Audience Feedback Activity 3, 5 ,  
Consumer Audience Feedback Team Screener 1
HCP Audience Feedback Activity 4, 5 ,  
HCP Audience Feedback Team Screener 2

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 12,300 12,300 0 0 0 0
Annual Time Burden (Hours) 3,528 3,528 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No