Information Collection

[OADC] CDC-INFO Web-based Satisfaction Survey

IC 274472 under ICR 202505-0920-006 · OMB 0920-1050.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1050 can be found here:

2025-06-23 - Revision of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-25-0011 [OADC] CDC-INFO Web-based Satisfaction Survey	Form
Form 0920-25-0011 2025 CDC-INFO Email Survey ENGLISH [OADC] CDC-INFO Web-based Satisfaction Survey	Form
Form 0920-25-0011 2025 CDC-INFO Email Survey SPANISH [OADC] CDC-INFO Web-based Satisfaction Survey	Form
0920-25-0011 2025 CDC-INFO Email Survey ENGLISH 2025 CDC-INFO Email Survey ENGLISH.docx	Form
0920-25-0011 2025 CDC-INFO Email Survey ENGLISH 2025 CDC-INFO Email Survey ENGLISH.docx	Form
0920-25-0011 2025 CDC-INFO Email Survey SPANISH 2025 CDC-INFO Email Survey SPANISH.docx	Form
0920-25-0011 2025 CDC-INFO Email Survey SPANISH 2025 CDC-INFO Email Survey SPANISH.docx	Form
CDC-INFO_Email_SPANISH_Survey Monkey Screenshot_Image 1.PNG CDC-INFO_Email_SPANISH_Survey Monkey Screenshot_Image 1	IC Document
CDC-INFO_Email_SPANISH_Survey Monkey Screenshot_Image 1.PNG CDC-INFO_Email_SPANISH_Survey Monkey Screenshot_Image 1	IC Document
CDC-INFO_Email_SPANISH_Survey Monkey Screenshot_Image 2.PNG CDC-INFO_Email_SPANISH_Survey Monkey Screenshot_Image 2	IC Document
CDC-INFO_Email_SPANISH_Survey Monkey Screenshot_Image 2.PNG CDC-INFO_Email_SPANISH_Survey Monkey Screenshot_Image 2	IC Document
CDC-INFO_Email_SPANISH_Survey Monkey Screenshot_Image 3.PNG CDC-INFO_Email_SPANISH_Survey Monkey Screenshot_Image 3	IC Document
CDC-INFO_Email_SPANISH_Survey Monkey Screenshot_Image 3.PNG CDC-INFO_Email_SPANISH_Survey Monkey Screenshot_Image 3	IC Document
CDC-INFO_Email_Survey Monkey Screenshot_Image 1.PNG CDC-INFO_Email_Survey Monkey Screenshot_Image 1	IC Document
CDC-INFO_Email_Survey Monkey Screenshot_Image 1.PNG CDC-INFO_Email_Survey Monkey Screenshot_Image 1	IC Document
CDC-INFO_Email_Survey Monkey Screenshot_Image 3.PNG CDC-INFO_Email_Survey Monkey Screenshot_Image 3	IC Document
CDC-INFO_Email_Survey Monkey Screenshot_Image 3.PNG CDC-INFO_Email_Survey Monkey Screenshot_Image 3	IC Document
Generic Clearance Submission Template_10-2025_Email Survey_Individual Respondents.docx Generic Clearance Submission Template_10-2025_Email Survey_Individual Respondents	IC Document
Generic Clearance Submission Template_10-2025_Email Survey_Individual Respondents.docx Generic Clearance Submission Template_10-2025_Email Survey_Individual Respondents	IC Document
Generic Clearance Submission Template_10-2025_Email Survey_Private Sector Respondents.docx Generic Clearance Submission Template_10-2025_Email Survey_Private Sector Respondents	IC Document
Generic Clearance Submission Template_10-2025_Email Survey_Private Sector Respondents.docx Generic Clearance Submission Template_10-2025_Email Survey_Private Sector Respondents	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

[OADC] CDC-INFO Web-based Satisfaction Survey

Agency IC Tracking Number:

0920-25-0011

IC Status: Unchanged

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	0920-25-0011				Yes	Yes	Fillable Fileable
Form	0920-25-0011				Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,600

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	1,600	1,600
Annual IC Time Burden (Hours)	80	80
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
CDC-INFO_Email_SPANISH_Survey Monkey Screenshot_Image 1		03/19/2025
CDC-INFO_Email_SPANISH_Survey Monkey Screenshot_Image 2		03/19/2025
CDC-INFO_Email_SPANISH_Survey Monkey Screenshot_Image 3		03/19/2025
CDC-INFO_Email_Survey Monkey Screenshot_Image 1		03/19/2025
CDC-INFO_Email_Survey Monkey Screenshot_Image 3		03/19/2025
Generic Clearance Submission Template_10-2025_Email Survey_Individual Respondents		03/19/2025
Generic Clearance Submission Template_10-2025_Email Survey_Private Sector Respondents		03/19/2025

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

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