[NCEZID] Hospital System Approach to Collecting Race, Ethnicity, and Language Data

[OS] CDC/ATSDR Formative Research and Tool Development

OMB: 0920-1154

IC ID: 267631

Documents and Forms
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Document Type
Form
Form
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
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Information Collection (IC) Details

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[NCEZID] Hospital System Approach to Collecting Race, Ethnicity, and Language Data 0920-1154-24FT
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 092061154 NHSN’s REaLI Effort Attachment 1_SDOH Redcap Survey - Final V4.1.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

13 0
   
Private Sector Businesses or other for-profits
 
   100 %

  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 13 0 0 0 0 13
Annual IC Time Burden (Hours) 7 0 0 0 0 7
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Request for genIC Approval (24FT) REaL Data_GenIC Requestv2.docx 05/28/2024
SSA (24FT) REaL Data_Supporting Statement A (0920-1154)_v3.docx 05/28/2024
SSB (24FT) REaL Data_Supporting Statement B (0920-1154).docx 05/15/2024
IRB Determination (24FT) Attachment 2_IRB Determination.pdf 05/15/2024
CoLab REaLI_Partner's final letter (24FT) Attachment 3_CoLab REaLI final letter_v2.docx 05/28/2024
CoLab REaLI_2nd reminder w/email (24FT) Attachment 4_CoLab reminder 2 w email final.docx 05/15/2024
CoLab REaLI_final reminder email (24FT) Attachment 5_CoLAB reminder final email.docx 05/15/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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