Formative Research Legionella

Focus Group Testing to Effectively Plan and Tailor Cancer Prevention and Control Communication Campaigns

OMB: 0920-0800

IC ID: 223243

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Information Collection (IC) Details

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Formative Research Legionella 16BCR
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-WORD Attachment 3 Building Managers and Water Maintenance Staff_Screener.docx Yes Yes Fillable Printable
Other-WORD Attachment 4 Water System Risk Managment and Remediation Staff_Screener.docx Yes Yes Fillable Printable
Other-WORD Attachment 9 Treating Clinician_Interview Guide.docx No   Paper Only
Other-WORD Attachment 10 Infection Control Clinician_Interview Guide.docx No   Paper Only
Other-WORD Attachment 11 Building Managers and Water Maintenance Staff_Interview Guide.docx No   Paper Only
Other-WORD Attachment 1 Treating Clinician_Screener.docx Yes Yes Fillable Printable
Other-WORD Attachment 2 Infection Control Clinician_Screener.docx Yes Yes Fillable Printable
Other-WORD Attachment 12 Water System Risk Management and Remediation Staff_Interview Guide.docx No   Paper Only

Health Illness Prevention

 

144 0
   
Individuals or Households
 
   100 %

  Approved 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 144 0 144 0 0 0
Annual IC Time Burden (Hours) 66 0 66 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Att 5_Treating Clinician Consent Attachment 5 Treating Clinician_Consent Form.doc 08/29/2016
Att 6_ Infection Control Clinician Consent Attachment 6 Infection Control Clinician_Consent Form.doc 08/29/2016
Att 7_Building Mgr and Water Maint. Staff Consent Attachment 7 Building Managers and Water Maintenance Staff_Consent Form.doc 08/29/2016
Att 8_Water System Risk Mgmt & Remediation Staff Consent Attachment 8 Water System Risk Management and Remediation Staff_Consent Form.doc 08/29/2016
Att 13_Treating Clinician_Test materials Attachment 13 Treating Clinician_Test Materials.pdf 08/29/2016
Att 14_Infection Control Clinician_Test materials Attachment 14 Infection Control Clinician_Test Materials.pdf 08/29/2016
Att 15_Bldg Mgrs and Water Maint. Staff_ Test materials Attachment 15 Building Managers and Water Maintenance Staff_Test Materials.pdf 08/29/2016
Att 16_Water Risk Mgmt and Remediation Staff_Test materials Attachment 16 Water System Risk Management and Remediation Staff_Test Materials.pdf 08/29/2016
Att 17_Email Instructions_Interview Participation Attachment 17 Email Instructions_Interview Participation.docx 08/29/2016
Att 18_Remote Testing Procedures Attachment 18 Remote Testing Procedures.docx 08/29/2016
Supporting Statement A SS A 2016 Legionella_8 29 2016 final.docx 08/29/2016
Supporting Statement B SS B 2016 Legionella_8 29 2016 final.docx 08/29/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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