OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

[NCEZID] Wastewater Surveillance Communication Evaluation: Assessing Water Surveillance Messages, Knowledge, and Attitudes (24CP)

IC 264849 under ICR 202503-0920-028 · OMB 0920-1154.

Documents and Forms
Document Name
Document Type
Form
Form
Other-Consent
Other-Consent
Form
Form
Form
Form
Form and Instruction
Form and Instruction
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

[NCEZID] Wastewater Surveillance Communication Evaluation: Assessing Water Surveillance Messages, Knowledge, and Attitudes (24CP) 0920-1154-24CP
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0920-1154 Screening/Eligibility Form for Focus Groups Attachment #1 - Eligibility Screener.docx No   Fillable Fileable
Form 0920-1154 Eligible Participant Screener for Focus Group (24CP) Attachment #3 - Eligible Participant Screener_FG_DA.docx No   Fillable Fileable
Other-Consent Attachment #5 - Respondent Consent Form_FG.docx No   Printable Only
Form and Instruction 0920-1154 Focus Group Moderator Guide (24CP) Attachment #8 - Focus Group Moderator Guide_.docx No   Fillable Fileable

Health Public Health Monitoring

 

180 0
   
Individuals or Households
 
   50 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 180 0 0 0 0 180
Annual IC Time Burden (Hours) 83 0 0 0 0 83
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Recruitment Materials (General and Post) Attachment #2 - Recruitment Materials_FG.docx 02/01/2024
Project Staff Agreement of Privacy Attachment #4 - Privacy Agreement.docx 02/01/2024
Invitation (Standard)_ Focus Group Attachment #6 - Standard Invitation_FG.docx 02/01/2024
Participant Confirmation Email Attachment #7 - Participant Confirmation Email_FG.docx 02/01/2024
Messages to be Tested Attachment #9- messages to be tested NWSS.docx 02/01/2024
Human Subjects Determination Attachment #10- Human Subjects Determination.pdf 02/01/2024
Request for Approval under the “Generic Clearance for the Collection of Formative Research and Tool Development” (OMB Control Number: 0920-1154) 24CP GenIC Request_Wastewater.020524 (24CP).docx 02/05/2024
SSA (24CP) SSA.020524_(24CP).docx 02/05/2024
SSB [0920-1154-24CP] SSB (24CP).docx 02/01/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.