Information Collection Request

[NCCDPHP] Evaluating Deep Learning Algorithm Assessment of Digital Photographs for Dental Public Health Surveillance

ICR 202309-0920-003 · OMB 0920-1420 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 0920-23FJ Screening/photo form_Screener Form and Instruction New Missing upstream
Form 0920-23FJ Screening/photo form_Child Form and Instruction New Repair queued
Form 0920-23FJ Consent Form and Instruction New Repair queued
Attachment 2C_Data collection app screenshot.docx Supplementary Document Uploaded 2023-10-18 Repair queued
Attachment 2F_Notice screening results.docx Supplementary Document Uploaded 2023-09-07 Missing upstream
Attachment 2D_School invitation.docx Supplementary Document Uploaded 2023-09-07 Available
Attachment 3A_60 day FRN.pdf Supplementary Document Uploaded 2023-09-07 Repair queued
Attachment 4_CDC IRB determination.docx Supplementary Document Uploaded 2023-09-07 Missing upstream
privacy-narrative-form_mHealth_08282023.pdf Supplementary Document Uploaded 2023-09-07 Missing upstream
Attachment 1_Legislation.pdf Supplementary Document Uploaded 2023-09-07 Repair queued
SSB_08292023_clean.docx Supporting Statement B Uploaded 2023-09-07 Missing upstream
SSA_08292023_clean.docx Supporting Statement A Uploaded 2023-09-07 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
262859 Screening/photo form_Screener Form and Instruction New
262858 Screening/photo form_Child Form and Instruction New
262856 Consent Form and Instruction New

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved
2,006 0
827 0
56,033 0





Reginfo record details
3
table that charts list of burden
IC Title Form No. Form Name
Consent 0920-23FJ Attachment 2E_Parent consent
Screening/photo form_Child 0920-23FJ Attachment 2A_Data collection form A
Screening/photo form_Screener 0920-23FJ Attachment 2B_Data collection form B

table that charts list of burden
  Total Request 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 2,006 0 0 2,006 0 0
Annual Time Burden (Hours) 827 0 0 827 0 0
Annual Cost Burden (Dollars) 56,033 0 0 56,033 0 0


Reginfo record details
  No