ATSDR Communication Activities Survey (ACAS)

OMB 0923-0055

The ACAS will be used to ascertain the effectiveness, and to evaluate the differences and consistency, of ATSDR activity delivery and respondent perceptions across sites and over time; determine how effectively ATSDR's site team engages community members; and discover how well ATSDR provides effective, clear and consistent communication and information on how to promote healthy and safe environments and prevent harmful exposures through the activities they implement in communities.

The latest form for ATSDR Communication Activities Survey (ACAS) expires 2020-06-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Agency Stakeholders - SMS Text Survey Form and Instruction
Community Members - SMS Text Survey Form and Instruction
Agency Stakeholders - ACAS Telephone Form and Instruction
Agency Stakeholders - ACAS Online Form and Instruction
Agency Stakeholders - ACAS Hard Copy Form and Instruction
Agency Stakeholders - ACAS Sign-In Sheet Form
Community Members - ACAS Telephone Form and Instruction
Community Members - ACAS Online Form and Instruction
Community Members - ACAS Hard Copy Form and Instruction
Community Members - Sign-In Sheet Form and Instruction
AttI ACAS Research Determination 20161212.pdf Supplementary Document
AttG Initial Email for Online ACAS Link 20201130.docx Supplementary Document
AttD Communty Mtng Fact Sheet 20201130.docx Supplementary Document
AttC ACAS PIA CPO Signed 20200804.pdf Supplementary Document
AttC 3rd_Party_SSP_ACAS_ISSO_20200610.pdf Supplementary Document
AttC 3rd_Party_PIA_ACAS 20200610.pdf Supplementary Document
AttB ACAS 60-day FRN.pdf Supplementary Document
AttA3 SARA AuthLegsl.pdf Supplementary Document
AttA2 RCRA AuthLegsl.pdf Supplementary Document
AttA1 CERCLA AuthLegsl.pdf Supplementary Document
1 - ACAS List of Attachments 20201130.docx Supplementary Document
1 - ACAS SSA 20201210.docx Supporting Statement A
1-SSB-20201130.docx Supporting Statement B
Agency Stakeholders - SMS Text Survey Form and Instruction
Community Members - SMS Text Survey Form and Instruction
Agency Stakeholders - ACAS Telephone Form and Instruction
Agency Stakeholders - ACAS Online Form and Instruction
Agency Stakeholders - ACAS Hard Copy Form and Instruction
Agency Stakeholders - ACAS Sign-In Sheet Form
Community Members - ACAS Telephone Form and Instruction
Community Members - ACAS Online Form and Instruction
Community Members - ACAS Hard Copy Form and Instruction
Community Members - Sign-In Sheet Form and Instruction

All Historical Document Collections

202012-0923-001	Reinstatement with change of a previously approved collection	2020-12-14
201612-0923-001 Approved with change	New collection (Request for a new OMB Control Number)	2017-01-05

OMB Details

Community Members - Sign-In Sheet

Federal Enterprise Architecture: Health - Consumer Health and Safety

Form NA

ATSDR Public Meeting Sign-In Sheet

Form and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.