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Pandemic Influenza Nonpharmaceutical Intervention Message Testing
CDC and ATSDR Health Message Testing System
OMB: 0920-0572
IC ID: 203482
OMB.report
HHS/CDC
OMB 0920-0572
ICR 201501-0920-003
IC 203482
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0572 can be found here:
2024-10-18 - Revision of a currently approved collection
2021-08-31 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Pandemic Influenza Nonpharmaceutical Intervention Message Testing
Form and Instruction
Screener
Screener Protocol 071312.docx
Form and Instruction
Moderator's Guide
Moderator Guide_071312.docx
Form and Instruction
Incentive Justification_071312.docx
Incentive Justification
IC Document
Focus Group Materials_071312.docx
Focus Group Materials
IC Document
HMTS NCEZID Expedited Review Form_071312.pdf
GenIC Review Form - Project Proposal
IC Document
Privacy Act Determination_071312.docx
Privacy Act Determination
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Pandemic Influenza Nonpharmaceutical Intervention Message Testing
Agency IC Tracking Number:
IC Status:
Unchanged
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
none
Screener
Screener Protocol 071312.docx
No
No
Paper Only
Form and Instruction
none
Moderator's Guide
Moderator Guide_071312.docx
No
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Immunization Management
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
90
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
90
0
0
0
0
90
Annual IC Time Burden (Hours)
180
0
0
0
0
180
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Incentive Justification
Incentive Justification_071312.docx
07/23/2012
Focus Group Materials
Focus Group Materials_071312.docx
07/23/2012
GenIC Review Form - Project Proposal
HMTS NCEZID Expedited Review Form_071312.pdf
07/23/2012
Privacy Act Determination
Privacy Act Determination_071312.docx
07/23/2012
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.