Attachment F OMB No. 0920-1185
Expiration Date: 03/31/2026
National Center for Health Statistics
Data Detectives Summer Camp
From the Office of
Management and Budget
(OMB No. 0920-1185, Expiration Date: 03/31/2026):
NOTICE
- Public reporting
burden of this collection of information is estimated to average 10
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 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 comments regarding this
burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden to:
CDC/ATSDR Information Collection Review Office; 1600 Clifton Road,
MS D-74, Atlanta, GA 30333, ATTN: PRA (0920-1185). Assurance
of Confidentiality - We
take your privacy very seriously. All information that relates to or
describes identifiable characteristics of individuals, a practice,
or an establishment will be used only for statistical purposes. NCHS
staff, contractors, and agents will not disclose or release
responses in identifiable form without the consent of the individual
or establishment in accordance with section 308(d) of the Public
Health Service Act (42 U.S.C. 242m(d)) and the Confidential
Information Protection and Statistical Efficiency Act of 2018
(CIPSEA Pub. L. No. 115-435, 132 Stat. 5529 § 302). In
accordance with CIPSEA, every NCHS employee, contractor, and agent
has taken an oath and is subject to a jail term of up to five years,
a fine of up to $250,000, or both if he or she willfully discloses
ANY identifiable information about you. In addition to the above
cited laws, NCHS complies with the Federal Cybersecurity Enhancement
Act of 2015 (6 U.S.C. §§ 151 and 151 note) which protects
Federal information systems from cybersecurity risks by screening
their networks.
We would appreciate your evaluation of the NCHS Data Detectives Summer Camp, by completing a short questionnaire (parent camp evaluation form).
This questionnaire is voluntary and should take less than 10 minutes to complete. It has been designed so that no individually identifiable information will be released. Please be sure not to include any identifiable information pertaining to the questionnaire. If you have any questions please contact us via email, at [email protected] .
The findings of this questionnaire will be used to help NCHS better serve you and the public.
We greatly appreciate your time and feedback. Thank you for providing valuable customer feedback to the National Center for Health Statistics (NCHS).
Overall, how would you rate your experience with the Data Detectives Camp?
Excellent
Very Good
Average
Poor
Have no opinion
How was your registration experience?
Excellent
Very Good
Average
Poor
Have no opinion
2a. Tell us more about your registration experience: _______________________
How was your child's experience here?
Excellent
Very Good
Average
Poor
Have no opinion
3a. Tell us more about your child's experience here: _________________________
How did our staff do?
Excellent
Very Good
Average
Poor
Have no opinion
4a. How could our staff do better? ______________________________
Would you recommend our program to others/another family?
Yes
Not sure
No
5a. If no, why not? ___________________________________________
Please share the things from your experience that you and/or your child will remember, either positive or otherwise. ___________________________________________________________________
Anything else we should know? _____________________________________________________
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Ryne |
File Modified | 0000-00-00 |
File Created | 2023-08-28 |