[CSELS/DLS]CDC OneLab Network Formative Evaluation

[OS] CDC/ATSDR Formative Research and Tool Development

Documents and Forms

Document Name Document Type
Form 0920-1154-24AR [CSELS/DLS]CDC OneLab Network Formative Evaluation Form and Instruction
0920-1154-24AR 04_Attachment 1_OneLab Network Survey_10-26-2023 04_Attachment 1_OneLab Network Survey_10-26-2023.docx Form and Instruction
01_Formative Research_GenIC_Request_CDC OneLab Network Evaluation_10-26-23.docx Request for Approval IC Document
02_Supporting Statement A_OneLab Network_10-26-23.docx SSA IC Document
03_Supporting Statement B_OneLab Network Social Network Survey10-26-2023.docx SSB IC Document
05_Attachment 2_Invitation and emails to participants_OneLab Network Surveys_10-26-2023.docx 05_Attachment 2_Invitation and emails to participants_OneLab Network Surveys_10-26-2023 IC Document
06_Attachment 3_OneLab Network OnePager_05102023.pdf 06_Attachment 3_OneLab Network OnePager_05102023 IC Document
07_Attachment 4_Project Determination_Human Subject Research Determination_OneLab Network.pdf 07_Attachment 4_Project Determination_Human Subject Research Determination_OneLab Network IC Document

Information Collection (IC) Details

IC Title:	[CSELS/DLS]CDC OneLab Network Formative Evaluation	Agency IC Tracking Number:	0920-1154-24AR

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	0920-1154-24AR	04_Attachment 1_OneLab Network Survey_10-26-2023	04_Attachment 1_OneLab Network Survey_10-26-2023.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 30	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	30	30
Annual IC Time Burden (Hours)	2	2
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Request for Approval	01_Formative Research_GenIC_Request_CDC OneLab Network Evaluation_10-26-23.docx	11/03/2023
SSA	02_Supporting Statement A_OneLab Network_10-26-23.docx	11/03/2023
SSB	03_Supporting Statement B_OneLab Network Social Network Survey10-26-2023.docx	11/03/2023
05_Attachment 2_Invitation and emails to participants_OneLab Network Surveys_10-26-2023	05_Attachment 2_Invitation and emails to participants_OneLab Network Surveys_10-26-2023.docx	11/03/2023
06_Attachment 3_OneLab Network OnePager_05102023	06_Attachment 3_OneLab Network OnePager_05102023.pdf	11/03/2023
07_Attachment 4_Project Determination_Human Subject Research Determination_OneLab Network	07_Attachment 4_Project Determination_Human Subject Research Determination_OneLab Network.pdf	11/03/2023

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