Information Collection Request

CDC and ATSDR Health Message Testing System

ICR 202504-0920-021 · OMB 0920-0572 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Change Request Memo - EO14168 Template NCCDPHP_SFL Message Testing 3.21.25.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-04-23 Available
Change Request Memo - EO14168 Template NCCDPHP_SFL Message Testing 3.21.25.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-04-23 Repair queued
Attachment G. Screener_Spanish_online version_3.13.25_clean.docx Supplementary Document Uploaded 2025-04-23 Available
Attachment G. Screener_Spanish_online version_3.13.25_clean.docx Supplementary Document Uploaded 2025-04-23 Missing upstream
Attachment D. Screener_English_paper version_3.21.25_clean.docx Supplementary Document Uploaded 2025-04-23 Available
Attachment D. Screener_English_paper version_3.21.25_clean.docx Supplementary Document Uploaded 2025-04-23 Repair queued
Attachment 12 - Examples-Data Collection Instruments 060308.docx Supplementary Document Uploaded 2025-04-08 Available
Attachment 12 - Examples-Data Collection Instruments 060308.docx Supplementary Document Uploaded 2025-04-08 Repair queued
Attachment 11 - Theory-based Drivers of Behavior.docx Supplementary Document Uploaded 2025-04-08 Available
Attachment 11 - Theory-based Drivers of Behavior.docx Supplementary Document Uploaded 2025-04-08 Repair queued
Attachment 10 - Follow-up questions.docx Supplementary Document Uploaded 2025-04-08 Available
Attachment 10 - Follow-up questions.docx Supplementary Document Uploaded 2025-04-08 Missing upstream
Attachment 9 - Activity-Task Questions.docx Supplementary Document Uploaded 2025-04-08 Available
Attachment 9 - Activity-Task Questions.docx Supplementary Document Uploaded 2025-04-08 Repair queued
Attachment 8- Core Questions.docx Supplementary Document Uploaded 2025-04-08 Available
Attachment 8- Core Questions.docx Supplementary Document Uploaded 2025-04-08 Repair queued
Attachment 7 - Introductory Questions.docx Supplementary Document Uploaded 2025-04-08 Available
Attachment 7 - Introductory Questions.docx Supplementary Document Uploaded 2025-04-08 Missing upstream
Attachment 6 - Market Research Experience Questions.docx Supplementary Document Uploaded 2025-04-08 Available
Attachment 6 - Market Research Experience Questions.docx Supplementary Document Uploaded 2025-04-08 Repair queued
Attachment 5 - Demographics - Clean Copy - 2.28.2025.docx Supplementary Document Uploaded 2025-04-08 Available
Attachment 5 - Demographics - Clean Copy - 2.28.2025.docx Supplementary Document Uploaded 2025-04-08 Repair queued
Attachment 4 - Overview.docx Supplementary Document Uploaded 2025-04-08 Available
Attachment 4 - Overview.docx Supplementary Document Uploaded 2025-04-08 Repair queued
Attachment 3 - Health Message Testing System Expedited Review Form .docx Supplementary Document Uploaded 2025-04-08 Available
Attachment 3 - Health Message Testing System Expedited Review Form .docx Supplementary Document Uploaded 2025-04-08 Repair queued
Att 1-AuthLegislation.pdf Supplementary Document Uploaded 2025-04-08 Available
Att 1-AuthLegislation.pdf Supplementary Document Uploaded 2025-04-08 Missing upstream
FRN-60day-2024.pdf Supplementary Document Uploaded 2024-10-18 Available
FRN-60day-2024.pdf Supplementary Document Uploaded 2024-10-18 Repair queued
Attachment 3 - Health Message Testing System Expedited Review Form .docx Justification for No Material/Nonsubstantive Change Uploaded 2024-10-18 Available
Attachment 3 - Health Message Testing System Expedited Review Form .docx Justification for No Material/Nonsubstantive Change Uploaded 2024-10-18 Repair queued
Att 1-AuthLegislation.pdf Supplementary Document Uploaded 2024-10-18 Available
Att 1-AuthLegislation.pdf Supplementary Document Uploaded 2024-10-18 Repair queued
30dy240572.docx Supplementary Document Uploaded 2024-10-18 Available
30dy240572.docx Supplementary Document Uploaded 2024-10-18 Repair queued
Attachment 3 - Health Message Testing System Expedited Review Form .docx Supplementary Document Uploaded 2021-08-30 Available
Attachment 3 - Health Message Testing System Expedited Review Form .docx Supplementary Document Uploaded 2021-08-30 Missing upstream
60dy210572 0052.docx Supplementary Document Uploaded 2021-08-30 Available
60dy210572 0052.docx Supplementary Document Uploaded 2021-08-30 Repair queued
Attachment 4-DemographicQuestions.docx Supplementary Document Uploaded 2021-08-05 Available
Attachment 4-DemographicQuestions.docx Supplementary Document Uploaded 2021-08-05 Repair queued
Attachment 5-MarketResearchExpQuestions.docx Supplementary Document Uploaded 2021-08-05 Available
Attachment 5-MarketResearchExpQuestions.docx Supplementary Document Uploaded 2021-08-05 Missing upstream
Attachment 6-IntroductoryQuestions.docx Supplementary Document Uploaded 2021-08-05 Available
Attachment 6-IntroductoryQuestions.docx Supplementary Document Uploaded 2021-08-05 Repair queued
Attachment 7-CoreQuestions.docx Supplementary Document Uploaded 2021-08-05 Available
Attachment 7-CoreQuestions.docx Supplementary Document Uploaded 2021-08-05 Repair queued
Attachment 8-ActivityTaskQuestions.docx Supplementary Document Uploaded 2021-08-05 Available
Attachment 8-ActivityTaskQuestions.docx Supplementary Document Uploaded 2021-08-05 Repair queued
Attachment 9-FollowUpQuestions.docx Supplementary Document Uploaded 2021-08-05 Available
Attachment 9-FollowUpQuestions.docx Supplementary Document Uploaded 2021-08-05 Repair queued
Attachment 10 - Examples-Data Collection Instruments 060308.docx Supplementary Document Uploaded 2021-08-05 Available
Attachment 10 - Examples-Data Collection Instruments 060308.docx Supplementary Document Uploaded 2021-08-05 Repair queued
Att 1-AuthLegislation.pdf Supplementary Document Uploaded 2021-08-05 Available
Att 1-AuthLegislation.pdf Supplementary Document Uploaded 2021-08-05 Repair queued
Attachment 11 - IRB Ruling 060308.docx Supplementary Document Uploaded 2021-08-05 Available
Attachment 11 - IRB Ruling 060308.docx Supplementary Document Uploaded 2021-08-05 Available
SS-PartB-HMTS - Clean Copy - 2.20.2025.docx Supporting Statement B Uploaded 2025-04-08 Available
SS-PartB-HMTS - Clean Copy - 2.20.2025.docx Supporting Statement B Uploaded 2025-04-08 Missing upstream
SS-Part A - Clean Copy - 2.20.2025.docx Supporting Statement A Uploaded 2025-04-08 Available
SS-Part A - Clean Copy - 2.20.2025.docx Supporting Statement A Uploaded 2025-04-08 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
04/30/2028 04/30/2028 04/30/2028
55,575 0 55,575
7,410 0 7,410
0 0 0






table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 55,575 55,575 0 0 0 0
Annual Time Burden (Hours) 7,410 7,410 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No