Information Collection

[NCEZID] In-Depth Interviews about Infection Prevention and Control Practices in Long-Term Care Facilities

IC 275349 under ICR 202507-0920-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Document Name Document Type
[NCEZID] In-Depth Interviews about Infection Prevention and Control Practices in Long-Term Care Facilities Form and Instruction
DHQP Interview Screener Attachment 1_DHQP_Screener_4.16.25.docx Form and Instruction
DHQP Interview Screener Attachment 1_DHQP_Screener_4.16.25.docx Form and Instruction
Interview Guide: Resident and Family/Close Friend (Paire Attachment 4_DHQP_Resident and Family Guide_3.25.25_Final.docx Form and Instruction
Interview Guide: Resident and Family/Close Friend (Paire Attachment 4_DHQP_Resident and Family Guide_3.25.25_Final.docx Form and Instruction
Interview Guide: Family/Close Friend (Follow-Up Intervie Attachment 5_DHQP_Family Follow-Up Guide_4.16.25.docx Form and Instruction
Interview Guide: Family/Close Friend (Follow-Up Intervie Attachment 5_DHQP_Family Follow-Up Guide_4.16.25.docx Form and Instruction
Attachment 2_DHQP_Consent Form_Resident_4.16.25.docx Consent Form Resident IC Document
Attachment 2_DHQP_Consent Form_Resident_4.16.25.docx Consent Form Resident IC Document
Attachment 3_DHQP_Consent Form_Family or Friend_4.16.25.docx Consent Form Family or Friend IC Document
Attachment 3_DHQP_Consent Form_Family or Friend_4.16.25.docx Consent Form Family or Friend IC Document
Attachment 6_Human Subjects Determination Memo.pdf Research Determination IC Document
Attachment 6_Human Subjects Determination Memo.pdf Research Determination IC Document
DHQP_Gen IC Request Form_4.16.25.docx GenIC Request Template IC Document
DHQP_Gen IC Request Form_4.16.25.docx GenIC Request Template IC Document
DHQP_OMB Supporting Statement A_4.16.25.docx SSA IC Document
DHQP_OMB Supporting Statement A_4.16.25.docx SSA IC Document
DHQP_OMB Supporting Statement B_4.16.25.docx SSB IC Document
DHQP_OMB Supporting Statement B_4.16.25.docx SSB IC Document

Information Collection (IC) Details

IC Title	[NCEZID] In-Depth Interviews about Infection Prevention and Control Practices in Long-Term Care Facilities
IC Status	Unchanged
Obligation to Respond	Voluntary