GAOS Consumer Pre-Campaign Web Survey - Consumers

[NCEZID] Assessment for the Get Ahead of Sepsis Consumer and Healthcare Professional Campaign

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1384 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-XXXX GAOS Consumer Pre-Campaign Web Survey - Consumers Form and Instruction
0920-XXXX GAOS Consumer Pre-Campaign Web Survey Attachment C_GAOS Consumer Pre Campaign Screener and Survey_9.9.22.docx Form and Instruction
0920-XXXX GAOS Consumer Pre-Campaign Web Survey Attachment C_GAOS Consumer Pre Campaign Screener and Survey_9.9.22.docx Form and Instruction

Information Collection (IC) Details

IC Title:	GAOS Consumer Pre-Campaign Web Survey - Consumers	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-XXXX	GAOS Consumer Pre-Campaign Web Survey	Attachment C_GAOS Consumer Pre Campaign Screener and Survey_9.9.22.docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 945	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	945	945
Annual IC Time Burden (Hours)	315	315
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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