GAOS Consumer Pre-Campaign Web Survey - Consumers

[NCEZID] Assessment for the Get Ahead of Sepsis Consumer and Healthcare Professional Campaign

Documents and Forms

Document Name Document Type
GAOS Consumer Pre-Campaign Web Survey - Consumers Form and Instruction
GAOS Consumer Pre-Campaign Web Survey - Consumers Form and Instruction
GAOS Consumer Pre-Campaign Web Survey GAOS Consumer Pre-Campaign Web Survey - Consumers.docx Form and Instruction
GAOS Consumer Pre-Campaign Web Survey GAOS Consumer Pre-Campaign Web Survey - Consumers.docx Form and Instruction

Information Collection (IC) Details

IC Title:	GAOS Consumer Pre-Campaign Web Survey - Consumers	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	n/a	GAOS Consumer Pre-Campaign Web Survey	GAOS Consumer Pre-Campaign Web Survey - Consumers.docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 945	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	945	945
Annual IC Time Burden (Hours)	315	315
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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