4-Poster Deer Treatment Device Acceptability Survey

Lyme and other Tickborne Diseases Knowledge, Attitude, and Practice Surveys

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1150 can be found here:

Documents and Forms

Document Name Document Type
4-Poster Deer Treatment Device Acceptability Survey Form
CT survey CT Survey_revised for ICRO.pdf Form
NY Survey NY Survey_revised for ICRO.pdf Form
1_Recruitment areas.docx List of recruitment areas IC Document
3_Survey reminder postcard.pptx Reminder postcard IC Document
5_Survey video.pptx Survey video IC Document
6_Thank you letter.docx Thank you letter IC Document
7_CDC study website.docx Study website IC Document
8_4-Poster Acceptability_protocol_v1_011520.docx Study protocol IC Document
9_Human subjects determination.docx Research determination IC Document
SSA.docx Supporting statement A IC Document
SSB.docx Supporting statement B IC Document
2_Survey invitation postcard.pptx Survey invitation IC Document

Information Collection (IC) Details

IC Title:	4-Poster Deer Treatment Device Acceptability Survey	Agency IC Tracking Number:	0920-1150-20KS

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	none	CT survey	CT Survey_revised for ICRO.pdf		Yes	Yes	Fillable Fileable
Form	none	NY Survey	NY Survey_revised for ICRO.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	4,500	4,500
Annual IC Time Burden (Hours)	300	300
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
List of recruitment areas	1_Recruitment areas.docx	02/27/2020
Reminder postcard	3_Survey reminder postcard.pptx	02/27/2020
Survey video	5_Survey video.pptx	02/27/2020
Thank you letter	6_Thank you letter.docx	02/27/2020
Study website	7_CDC study website.docx	02/27/2020
Study protocol	8_4-Poster Acceptability_protocol_v1_011520.docx	02/27/2020
Research determination	9_Human subjects determination.docx	02/27/2020
Supporting statement A	SSA.docx	02/27/2020
Supporting statement B	SSB.docx	02/27/2020
Survey invitation	2_Survey invitation postcard.pptx	03/02/2020

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.