Information Collection Request

[NCEZID] Assessment for the Be Antibiotics Aware Consumer Campaign

ICR 202306-0920-012 · OMB 0920-1387 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
BAA HCP Post Campaign Screener and Survey Form and Instruction Modified Available
BAA HCP Post-Campaign web survey Form and Instruction Modified Repair queued
BAA HCP Pre Campaign Screener and Survey Form and Instruction Modified Available
BAA HCP Pre-Campaign web survey Form and Instruction Modified Repair queued
BAA Consumer Post Campaign Screener and Survey Form and Instruction Modified Available
BAA Consumer Post-Campaign web survey Form and Instruction Modified Repair queued
BAA Consumer Pre Campaign Screener and Survey Form and Instruction Modified Available
BAA Consumer Pre-Campaign web survey Form and Instruction Modified Repair queued
BAA Explanation of Changes_6.20.23.docx Justification for No Material/Nonsubstantive Change Uploaded 2023-06-23 Available
BAA Explanation of Changes_6.20.23.docx Justification for No Material/Nonsubstantive Change Uploaded 2023-06-23 Repair queued
Attachment G1_011620VI-NR-signed.pdf Supplementary Document Uploaded 2022-10-18 Available
Attachment G1_011620VI-NR-signed.pdf Supplementary Document Uploaded 2022-10-18 Repair queued
Attachment G2_011520VI-NR-signed.pdf Supplementary Document Uploaded 2022-10-18 Available
Attachment G2_011520VI-NR-signed.pdf Supplementary Document Uploaded 2022-10-18 Available
Attachment H_BAA Recruitment Invitation.docx Supplementary Document Uploaded 2022-10-18 Available
Attachment H_BAA Recruitment Invitation.docx Supplementary Document Uploaded 2022-10-18 Available
Attachment I_BAA Informed consent form.docx Supplementary Document Uploaded 2022-10-18 Available
Attachment I_BAA Informed consent form.docx Supplementary Document Uploaded 2022-10-18 Repair queued
Attachment J_BAA Reminder email.docx Supplementary Document Uploaded 2022-10-18 Available
Attachment J_BAA Reminder email.docx Supplementary Document Uploaded 2022-10-18 Repair queued
BAA Pilot Assessment Partner Intervention Plan_09.13.22_FINAL.docx Supplementary Document Uploaded 2022-10-18 Available
BAA Pilot Assessment Partner Intervention Plan_09.13.22_FINAL.docx Supplementary Document Uploaded 2022-10-18 Repair queued
Attachment A_Authorization Legislation.docx Supplementary Document Uploaded 2022-10-17 Available
Attachment A_Authorization Legislation.docx Supplementary Document Uploaded 2022-10-17 Repair queued
Supporting Statement B.docx Supporting Statement B Uploaded 2023-06-23 Available
Supporting Statement B.docx Supporting Statement B Uploaded 2023-06-23 Repair queued
Supporting Statement A.docx Supporting Statement A Uploaded 2023-06-23 Available
Supporting Statement A.docx Supporting Statement A Uploaded 2023-06-23 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
256482 BAA HCP Post-Campaign web survey Form and Instruction ModifiedBAA HCP Post Campaign Screener and Survey
256482 BAA HCP Post-Campaign web survey Form and Instruction Modified
256481 BAA HCP Pre-Campaign web survey Form and Instruction ModifiedBAA HCP Pre Campaign Screener and Survey
256481 BAA HCP Pre-Campaign web survey Form and Instruction Modified
256480 BAA Consumer Post-Campaign web survey Form and Instruction ModifiedBAA Consumer Post Campaign Screener and Survey
256480 BAA Consumer Post-Campaign web survey Form and Instruction Modified
256479 BAA Consumer Pre-Campaign web survey Form and Instruction ModifiedBAA Consumer Pre Campaign Screener and Survey
256479 BAA Consumer Pre-Campaign web survey Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
03/31/2026 03/31/2026 03/31/2026
2,522 0 2,522
842 0 842
0 0 0





Reginfo record details
4
table that charts list of burden
IC Title Form No. Form Name
BAA Consumer Post-Campaign web survey n/a
BAA Consumer Pre-Campaign web survey n/a
BAA HCP Post-Campaign web survey n/a
BAA HCP Pre-Campaign web survey n/a

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 2,522 2,522 0 0 0 0
Annual Time Burden (Hours) 842 842 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No