BAA HCP Post-Campaign web survey

[NCEZID] Assessment for the Be Antibiotics Aware Consumer Campaign

Documents and Forms

Document Name Document Type
BAA HCP Post-Campaign web survey Form and Instruction
BAA HCP Post-Campaign web survey Form and Instruction
BAA HCP Post Campaign Screener and Survey BAA HCP Post-Campaign web survey.docx Form and Instruction
BAA HCP Post Campaign Screener and Survey BAA HCP Post-Campaign web survey.docx Form and Instruction

Information Collection (IC) Details

IC Title:	BAA HCP Post-Campaign web survey	Agency IC Tracking Number:	0920-22CC

Is this a Common Form? No		IC Status: Modified

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	n/a	BAA HCP Post Campaign Screener and Survey	BAA HCP Post-Campaign web survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 788	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	788	788
Annual IC Time Burden (Hours)	263	263
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.