Information Collection

[NCEZID] Evaluation of communication between CDC and Association of Refugee Health Coordinators (ARHC) partners during responses in 2021-2022

IC 258090 under ICR 202403-0920-013 · OMB 0920-1071.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1071 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment 1 Survey Invitation.docx	Instruction
Attachment 1 Survey Invitation.docx	Instruction
0920-1071 Interview Consent and Questionnaire Attachment 2 Interview Questions.docx	Form and Instruction
0920-1071 Interview Consent and Questionnaire Attachment 2 Interview Questions.docx	Form and Instruction
0920-1071 Evaluation of Communication between Immigrant, Refugee M Attachment 3 Data Collection Tool.xlsx	Form
0920-1071 Evaluation of Communication between Immigrant, Refugee M Attachment 3 Data Collection Tool.xlsx	Form
Service Delivery Fast Track-Evaluation of Communication between CDC and ARHC partners.docx Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0920-105	IC Document
Service Delivery Fast Track-Evaluation of Communication between CDC and ARHC partners.docx Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0920-105	IC Document
Human Subjects Determination.pdf Human Subjects Determination	IC Document
Human Subjects Determination.pdf Human Subjects Determination	IC Document
Project Protocol.docx Project Protocol	IC Document
Project Protocol.docx Project Protocol	IC Document

IC Title:

[NCEZID] Evaluation of communication between CDC and Association of Refugee Health Coordinators (ARHC) partners during responses in 2021-2022

Agency IC Tracking Number:

0920-1071-23CI

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Attachment 1 Survey Invitation.docx	Yes	Yes	Printable Only
Form and Instruction	0920-1071	Interview Consent and Questionnaire	Attachment 2 Interview Questions.docx	No		Fillable Fileable
Form	0920-1071	Evaluation of Communication between Immigrant, Refugee Migrant Health Branch at CDC and ARHC partners during responses in 2020-2022	Attachment 3 Data Collection Tool.xlsx	No		Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 40

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	40	40
Annual IC Time Burden (Hours)	20	20
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Request for Approval under the âGeneric Clearance for the Collection of Routine Customer Feedbackâ (OMB Control Number: 0920-1050)	Service Delivery Fast Track-Evaluation of Communication between CDC and ARHC partners.docx	02/02/2023
Human Subjects Determination	Human Subjects Determination.pdf	02/02/2023
Project Protocol	Project Protocol.docx	02/02/2023

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