Information Collection

Post-exposure survey

IC 269801 under ICR 202407-0920-009 · OMB 0920-1438.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1438 can be found here:

2025-05-14 - No material or nonsubstantive change to a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-24CB Post-exposure survey	Form
Form 0920-24CB Post Exposure Survey _English Post-exposure survey	Form
Form 0920-24CB Post Exposure Survey _Spanish Post-exposure survey	Form
0920-24CB Post Exposure Survey _English Attachment 07f_Post-Exposure Survey_Online_English.docx	Form
0920-24CB Post Exposure Survey _English Attachment 07f_Post-Exposure Survey_Online_English.docx	Form
0920-24CB Post Exposure Survey _Spanish Attachment 07g_Post-Exposure Survey_Online_Spanish.docx	Form
0920-24CB Post Exposure Survey _Spanish Attachment 07g_Post-Exposure Survey_Online_Spanish.docx	Form
Attachment 07a_Post-Exposure Survey_Assigned Materials and Survey Link_English.docx Post-Exposure Survey_Assigned Materials and Survey Link_English	IC Document
Attachment 07a_Post-Exposure Survey_Assigned Materials and Survey Link_English.docx Post-Exposure Survey_Assigned Materials and Survey Link_English	IC Document
Attachment 07b_Post-Exposure Survey_Assigned Materials and Survey Link_Spanish.docx Post-Exposure Survey_Assigned Materials and Survey Link_Spanish	IC Document
Attachment 07b_Post-Exposure Survey_Assigned Materials and Survey Link_Spanish.docx Post-Exposure Survey_Assigned Materials and Survey Link_Spanish	IC Document
Attachment 07d_Post-Exposure Survey_Consent Statement_Spanish.docx Post-Exposure Survey_Consent Statement_Spanish	IC Document
Attachment 07d_Post-Exposure Survey_Consent Statement_Spanish.docx Post-Exposure Survey_Consent Statement_Spanish	IC Document
Attachment 07c_Post-Exposure Survey_Consent Statement_English.docx Post-Exposure Survey_Consent Statement_English	IC Document
Attachment 07c_Post-Exposure Survey_Consent Statement_English.docx Post-Exposure Survey_Consent Statement_English	IC Document
Attachment 07h_Post-Exposure Survey_Reminder Email_English.docx Post-Exposure Survey_Reminder Email_English	IC Document
Attachment 07h_Post-Exposure Survey_Reminder Email_English.docx Post-Exposure Survey_Reminder Email_English	IC Document
Attachment 07i_Post-Exposure Survey_Reminder Email_Spanish.docx Post-Exposure Survey_Reminder Email_Spanish	IC Document
Attachment 07i_Post-Exposure Survey_Reminder Email_Spanish.docx Post-Exposure Survey_Reminder Email_Spanish	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Post-exposure survey

Agency IC Tracking Number:

0920-24CB

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	0920-24CB				Yes	Yes	Fillable Fileable
Form	0920-24CB				Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 900

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	900	900
Annual IC Time Burden (Hours)	300	300
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Post-Exposure Survey_Assigned Materials and Survey Link_English		08/02/2024
Post-Exposure Survey_Assigned Materials and Survey Link_Spanish		08/02/2024
Post-Exposure Survey_Consent Statement_Spanish		08/02/2024
Post-Exposure Survey_Consent Statement_English		08/02/2024
Post-Exposure Survey_Reminder Email_English		08/02/2024
Post-Exposure Survey_Reminder Email_Spanish		08/02/2024

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

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