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Sepsis Campaign Development: Round 2 Concept/Materials Testing for Consumers
CDC and ATSDR Health Message Testing System
OMB: 0920-0572
IC ID: 227054
OMB.report
HHS/CDC
OMB 0920-0572
ICR 201502-0920-001
IC 227054
( )
⚠️ Notice: This information collection may be referencing outdated material.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
Sepsis Campaign Development: Round 2 Concept/Materials Testing for Consumers
Form
Screenshots of the Sepsis R2 Survey for Consumers
B.R2 Sepsis Consumer Survey Screenshots.pdf
Form
Sepsis R2_HMTSExpeditedReviewForm_v4 - Consumers.pdf
HMTS Form - Sepsis R2 Testing wtih Consumers
IC Document
Sepsis R2 Project Description_5.31.2017 - Consumers.docx
Project Description - Sepsis R2 Testing with Consumers
IC Document
C1.Visual with slogan_A.png
Test Item C1. Visual with Slogan_A
IC Document
C2.Visual with slogan_B.png
Test Item C2. Visual with Slogan_B
IC Document
C3.Visual with slogan_C.png
Test Item C3. Visual with Slogan_C
IC Document
C4.Visual with slogan_D.png
Test Item C4. Visual with Slogan_D
IC Document
C5.Visual with slogan_E.png
Test Item C5. Visual with Slogan_E
IC Document
C6.Sepsis_Print_Concept_A.pdf
Test Item C6. Print Concept_A
IC Document
C7.Sepsis_Print_Concept_B.pdf
Test Item C7. Print Concept_B
IC Document
C8.Sepsis_Print_Concept_C.pdf
Test Item C8. Print Concept_C
IC Document
C9.Sepsis Campaign Stimulus_TV Ads.docx
Test Item C9. Campaign Stimuls_TV Ads
IC Document
C11.CONSUMER Sepsis definition_ R2 testing_FINAL.docx
Test Item C11. Consumer Definition_Sepsis
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Sepsis Campaign Development: Round 2 Concept/Materials Testing for Consumers
Agency IC Tracking Number:
0920-17ANT
IC Status:
New
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
n/a
Screenshots of the Sepsis R2 Survey for Consumers
B.R2 Sepsis Consumer Survey Screenshots.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
198
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
198
0
198
0
0
0
Annual IC Time Burden (Hours)
24
0
24
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
HMTS Form - Sepsis R2 Testing wtih Consumers
Sepsis R2_HMTSExpeditedReviewForm_v4 - Consumers.pdf
06/05/2017
Project Description - Sepsis R2 Testing with Consumers
Sepsis R2 Project Description_5.31.2017 - Consumers.docx
06/05/2017
Test Item C1. Visual with Slogan_A
C1.Visual with slogan_A.png
06/05/2017
Test Item C2. Visual with Slogan_B
C2.Visual with slogan_B.png
06/05/2017
Test Item C3. Visual with Slogan_C
C3.Visual with slogan_C.png
06/05/2017
Test Item C4. Visual with Slogan_D
C4.Visual with slogan_D.png
06/05/2017
Test Item C5. Visual with Slogan_E
C5.Visual with slogan_E.png
06/05/2017
Test Item C6. Print Concept_A
C6.Sepsis_Print_Concept_A.pdf
06/05/2017
Test Item C7. Print Concept_B
C7.Sepsis_Print_Concept_B.pdf
06/05/2017
Test Item C8. Print Concept_C
C8.Sepsis_Print_Concept_C.pdf
06/05/2017
Test Item C9. Campaign Stimuls_TV Ads
C9.Sepsis Campaign Stimulus_TV Ads.docx
06/05/2017
Test Item C11. Consumer Definition_Sepsis
C11.CONSUMER Sepsis definition_ R2 testing_FINAL.docx
06/05/2017
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.