[NCEH] Evaluating Content and Usability of CDC's Clinical Heat Guidance

[OS] CDC/ATSDR Formative Research and Tool Development

OMB: 0920-1154

IC ID: 273021

Documents and Forms

Document Name Document Type
Form 0920-1154 [NCEH] Evaluating Content and Usability of CDC's Clinical Heat Guidance Form and Instruction
Form 0920-1154 [NCEH] Evaluating Content and Usability of CDC's Clinical Heat Guidance Form and Instruction
0920-1154 Physician - Survey for Community Health Center Physician Attachment 1. CDC Clinical Heat Guidance Survey Instrument.docx Form and Instruction
0920-1154 Physician - Survey for Community Health Center Physician Attachment 1. CDC Clinical Heat Guidance Survey Instrument.docx Form and Instruction
0920-1154 Non-Physician - Survey for Community Health Center Physi Attachment 1. CDC Clinical Heat Guidance Survey Instrument.docx Form and Instruction
0920-1154 Non-Physician - Survey for Community Health Center Physi Attachment 1. CDC Clinical Heat Guidance Survey Instrument.docx Form and Instruction
0920-1154 Physician - Survey for Community Health Center Physician Attachment 12. CDC Heat Guidance Survey Instrument_Spanish.docx Form and Instruction
0920-1154 Physician - Survey for Community Health Center Physician Attachment 12. CDC Heat Guidance Survey Instrument_Spanish.docx Form and Instruction
0920-1154 Non-Physician - Survey for Community Health Center Physi Attachment 12. CDC Heat Guidance Survey Instrument_Spanish.docx Form and Instruction
0920-1154 Non-Physician - Survey for Community Health Center Physi Attachment 12. CDC Heat Guidance Survey Instrument_Spanish.docx Form and Instruction
Attachement 3. Example of Programmed Survey.PNG Program Survey - Sample IC Document
Attachement 3. Example of Programmed Survey.PNG Program Survey - Sample IC Document
Attachment 2. Programmed CDC-Heat_Guidance Survey Flow.docx Program Survey - Sample Work Flow IC Document
Attachment 2. Programmed CDC-Heat_Guidance Survey Flow.docx Program Survey - Sample Work Flow IC Document
Attachment 7. Recruitment Flyer.png Recruitment Flyer IC Document
Attachment 7. Recruitment Flyer.png Recruitment Flyer IC Document
Attachments 4-6 - Recruitment, Reminder and Final Reminder Emails.docx Recruitment, Reminder and Final Reminder Emails IC Document
Attachments 4-6 - Recruitment, Reminder and Final Reminder Emails.docx Recruitment, Reminder and Final Reminder Emails IC Document
Attachment 9. Project determination.pdf Project Determination IC Document
Attachment 9. Project determination.pdf Project Determination IC Document
SSA - for CDC Clinical Heat Guidance Eval 12.13.24.docx Supporting Statement A IC Document
SSA - for CDC Clinical Heat Guidance Eval 12.13.24.docx Supporting Statement A IC Document
SSB - for CDC Clinical Heat Guidance Eval - GenIC 1154 -11.18.24.docx Supporting Statement B IC Document
SSB - for CDC Clinical Heat Guidance Eval - GenIC 1154 -11.18.24.docx Supporting Statement B IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	[NCEH] Evaluating Content and Usability of CDC's Clinical Heat Guidance	Agency IC Tracking Number:	0920-1154-25CD

IC Status: Unchanged

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	0920-1154	Physician - Survey for Community Health Center Physicians and Non-Physicians on CDC’s Clinician Heat Guidance	Attachment 1. CDC Clinical Heat Guidance Survey Instrument.docx	N/A	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1154	Non-Physician - Survey for Community Health Center Physicians and Non-Physicians on CDC’s Clinician Heat Guidance	Attachment 1. CDC Clinical Heat Guidance Survey Instrument.docx	N/A	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1154	Physician - Survey for Community Health Center Physicians and Non-Physicians on CDC’s Clinician Heat Guidance_Spanish	Attachment 12. CDC Heat Guidance Survey Instrument_Spanish.docx	N/A	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1154	Non-Physician - Survey for Community Health Center Physicians and Non-Physicians on CDC’s Clinician Heat Guidance_Spanish	Attachment 12. CDC Heat Guidance Survey Instrument_Spanish.docx	N/A	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	1,000	1,000
Annual IC Time Burden (Hours)	250	250
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Program Survey - Sample	Attachement 3. Example of Programmed Survey.PNG	12/13/2024
Program Survey - Sample Work Flow	Attachment 2. Programmed CDC-Heat_Guidance Survey Flow.docx	12/13/2024
Recruitment Flyer	Attachment 7. Recruitment Flyer.png	12/13/2024
Recruitment, Reminder and Final Reminder Emails	Attachments 4-6 - Recruitment, Reminder and Final Reminder Emails.docx	12/13/2024
Project Determination	Attachment 9. Project determination.pdf	12/13/2024
Supporting Statement A	SSA - for CDC Clinical Heat Guidance Eval 12.13.24.docx	12/13/2024
Supporting Statement B	SSB - for CDC Clinical Heat Guidance Eval - GenIC 1154 -11.18.24.docx	12/13/2024

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