Information Collection

In-Depth Interviews with Healthcare Professionals about C. Diff Materials

IC 266946 under ICR 202506-0920-010 · OMB 0920-1154.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form 0920-1154-24ES
In-Depth Interviews with Healthcare Professionals about C. Diff Materials
Form and Instruction
Form 0920-1154-24ES
Antimicrobial Resistance Communications and Media Support Services In-Depth Interviews with Healthcare Professionals about C. Diff Materials
Form and Instruction
Form 0920-1154-24ES
Antimicrobial Resistance Communications and Media Support Services_Guide HCPs (24ES) In-Depth Interviews with Healthcare Professionals about C. Diff Materials
Form and Instruction
0920-1154-24ES Antimicrobial Resistance Communications and Media Suppor
Attachment 1_CDC DHQP_Cdiff_IDI Screener_HCPs_4.12.24_Final.docx
Form and Instruction
0920-1154-24ES Antimicrobial Resistance Communications and Media Suppor
Attachment 1_CDC DHQP_Cdiff_IDI Screener_HCPs_4.12.24_Final.docx
Form and Instruction
0920-1154-24ES Antimicrobial Resistance Communications and Media Suppor
Attachment 3_CDC DHQP_Cdiff_IDI Guide_HCPs_3.18.24_Final.docx
Form and Instruction
0920-1154-24ES Antimicrobial Resistance Communications and Media Suppor
Attachment 3_CDC DHQP_Cdiff_IDI Guide_HCPs_3.18.24_Final.docx
Form and Instruction
Attachment 2_CDC DHQP_CDIFF IDI Consent Form_HCPs_3.18.24_Final.docx
Consent Form
IC Document
Attachment 2_CDC DHQP_CDIFF IDI Consent Form_HCPs_3.18.24_Final.docx
Consent Form
IC Document
Attachment 4_Human Subjects Determination.pdf
Project Determination (24ES)
IC Document
Attachment 4_Human Subjects Determination.pdf
Project Determination (24ES)
IC Document
CDC DHQP_CDIFF IDIs OMB Supporting Statement A_4.12.24_Final.docx
SSA
IC Document
CDC DHQP_CDIFF IDIs OMB Supporting Statement A_4.12.24_Final.docx
SSA
IC Document
CDC DHQP_CDIFF IDIs OMB Supporting Statement B_4.12.24_Final.docx
SSB
IC Document
CDC DHQP_CDIFF IDIs OMB Supporting Statement B_4.12.24_Final.docx
SSB
IC Document
CDC DHQP_CDIFF IDI Gen IC Request Form_HCPs_4.12.24_Final.docx
Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0920-105
IC Document
CDC DHQP_CDIFF IDI Gen IC Request Form_HCPs_4.12.24_Final.docx
Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0920-105
IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

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 and Instruction 0920-1154-24ES Yes Yes Fillable Fileable
Form and Instruction 0920-1154-24ES Yes Yes Fillable Fileable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  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 121 0 0 0 0 121
Annual IC Time Burden (Hours) 22 0 0 0 0 22
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
Consent Form 04/16/2024
Project Determination (24ES) 04/16/2024
SSA 04/17/2024
SSB 04/17/2024
Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0920-1050) 04/17/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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