Information Collection

[NCEZID] Communication Evaluation Assessing Foodborne, Waterborne and Mycotic Disease Prevention

IC 273434 under ICR 202503-0920-028 · OMB 0920-1154.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1154 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-1154 [NCEZID] Communication Evaluation Assessing Foodborne, Waterborne and Mycotic Disease Prevention	Form and Instruction
Form 0920-1154 Eligibility Screener - Focus Group [NCEZID] Communication Evaluation Assessing Foodborne, Waterborne and Mycotic Disease Prevention	Form and Instruction
Form 0920-1154 Eligible Participant Screener - Focus Group [NCEZID] Communication Evaluation Assessing Foodborne, Waterborne and Mycotic Disease Prevention	Form and Instruction
Form 0920-1154 Eligibility Screener - Survey [NCEZID] Communication Evaluation Assessing Foodborne, Waterborne and Mycotic Disease Prevention	Form and Instruction
Form 0920-1154 Focus Group Moderator Guide [NCEZID] Communication Evaluation Assessing Foodborne, Waterborne and Mycotic Disease Prevention	Form and Instruction
Form 0920-1154 Rapid Online Survey [NCEZID] Communication Evaluation Assessing Foodborne, Waterborne and Mycotic Disease Prevention	Form and Instruction
0920-1154 Eligibility Screener - Focus Group Attachment 1 - Eligibility Screener_FG.docx	Form and Instruction
0920-1154 Eligibility Screener - Focus Group Attachment 1 - Eligibility Screener_FG.docx	Form and Instruction
0920-1154 Eligible Participant Screener - Focus Group Attachment 3 - Eligible Participant Screener_FG.docx	Form and Instruction
0920-1154 Eligible Participant Screener - Focus Group Attachment 3 - Eligible Participant Screener_FG.docx	Form and Instruction
0920-1154 Eligibility Screener - Survey Attachment 9 - Eligibility Screener for Rapid Survey.docx	Form and Instruction
0920-1154 Eligibility Screener - Survey Attachment 9 - Eligibility Screener for Rapid Survey.docx	Form and Instruction
0920-1154 Focus Group Moderator Guide Attachment 8 - Focus Group Moderator Guide.docx	Form and Instruction
0920-1154 Focus Group Moderator Guide Attachment 8 - Focus Group Moderator Guide.docx	Form and Instruction
0920-1154 Rapid Online Survey Attachment 11 - Rapid Survey.docx	Form and Instruction
0920-1154 Rapid Online Survey Attachment 11 - Rapid Survey.docx	Form and Instruction
Attachment 2 - Recruitment Materials_FG.docx Recruitment Materials - FG	IC Document
Attachment 2 - Recruitment Materials_FG.docx Recruitment Materials - FG	IC Document
Attachment 5 - Respondent Consent Form_FG.docx Consent Form - FG	IC Document
Attachment 5 - Respondent Consent Form_FG.docx Consent Form - FG	IC Document
Attachment 6 - Standard Invitation_FG.docx Standard Invitation - FG	IC Document
Attachment 6 - Standard Invitation_FG.docx Standard Invitation - FG	IC Document
Attachment 7 - Participant Confirmation Email_FG.docx Participant Confirmation Email - FG	IC Document
Attachment 7 - Participant Confirmation Email_FG.docx Participant Confirmation Email - FG	IC Document
Attachment 13 - Recruitment Materials_Survey.docx Recruitment Materials - Survey	IC Document
Attachment 13 - Recruitment Materials_Survey.docx Recruitment Materials - Survey	IC Document
Attachment 12 - Respondent Consent Form_Survey.docx Consent Form - Survey	IC Document
Attachment 12 - Respondent Consent Form_Survey.docx Consent Form - Survey	IC Document
Attachment 15 - Messages to be tested.docx Test Messages	IC Document
Attachment 15 - Messages to be tested.docx Test Messages	IC Document
Attachment 16- Human Subjects Determination.pdf Non-Research Determination	IC Document
Attachment 16- Human Subjects Determination.pdf Non-Research Determination	IC Document
Attachment 4 - Privacy Agreement.docx Privacy Agreement	IC Document
Attachment 4 - Privacy Agreement.docx Privacy Agreement	IC Document
GenIC Request_DFWED.docx GenIC Request	IC Document
GenIC Request_DFWED.docx GenIC Request	IC Document
Supporting Statement A.docx Supporting Statement A	IC Document
Supporting Statement A.docx Supporting Statement A	IC Document
Supporting Statement B.docx Supporting Statement B	IC Document
Supporting Statement B.docx Supporting Statement B	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

[NCEZID] Communication Evaluation Assessing Foodborne, Waterborne and Mycotic Disease Prevention

Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-1154	N/A	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1154	N/A	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1154	N/A	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1154	N/A	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1154	N/A	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: 6,794

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	6,794	6,794
Annual IC Time Burden (Hours)	650	650
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Recruitment Materials - FG		12/30/2024
Consent Form - FG		12/30/2024
Standard Invitation - FG		12/30/2024
Participant Confirmation Email - FG		12/30/2024
Recruitment Materials - Survey		12/30/2024
Consent Form - Survey		12/30/2024
Test Messages		12/30/2024
Non-Research Determination		12/30/2024
Privacy Agreement		12/30/2024
GenIC Request		12/30/2024
Supporting Statement A		12/30/2024
Supporting Statement B		12/30/2024

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

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