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Federal forms, ICRs, and supporting documents

Information Collection Request

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

ICR 201711-0920-019 · OMB 0920-1071 · Active

Forms and Documents
DocumentTypeStatusAvailability
Year 5 (2020) Customer Satisfaction Survey for the CDC Antibiotic Resistance (AR) Isolate Bank Form and Instruction New Available
SEDRIC User Acceptance and Satisfaction Form New Repair queued
Year 4 (2019) Customer Satisfaction Survey for the CDC Antibiotic Resistance (AR) Isolate Bank Form and Instruction New Repair queued
Form 0920-1071 Acceptability Survey of ARI Campaign for University of Utah Pediatric Clinic Champions Form and Instruction New Repair queued
Form 0920-1071 Immigrant, Refugee, and Migrant Health (IRMH) Website Redesign Form and Instruction New Available
Survey to evaluate the Nursing Home Infection Preventionist Training Course Form and Instruction New Repair queued
Form 0920-1071 Dialysis Event Module Training Needs Assessment Form and Instruction New Repair queued
Form 0920-1071 Customer Satisfaction Survey for 2018 UNGA AMR Side Event Form and Instruction New Repair queued
Form 0920-1071 Customer Satisfaction Survey for CDC AR Isolate Bank Form and Instruction New Repair queued
Form 0920-1071 Tuberculosis Education Materials for Classified Immigrants Form and Instruction New Repair queued
Att. B - Generic_Clearance_for_Qualitative_Feedback_Template_Approval_Form[1] NCEZID.docx Supplementary Document Uploaded 2018-01-04 Repair queued
60-Day FRN 0920-1071 Extension.docx Supplementary Document Uploaded 2018-01-04 Repair queued
Att. A - Section 301 of the Public Health Service Act (42 USC 241).pdf Supplementary Document Uploaded 2018-01-04 Available
SSB_0920-1071_Extension_2017.docx Supporting Statement B Uploaded 2018-01-04 Available
SSA_0920-1071_Extension_2017.docx Supporting Statement A Uploaded 2018-01-08 Available
IC Document Collections
IC IDCollectionTypeStatusForm
242448 Year 5 (2020) Customer Satisfaction Survey for the CDC Antibiotic Resistance (AR) Isolate Bank Form and Instruction New
238995 SEDRIC User Acceptance and Satisfaction Form New
236913 Year 4 (2019) Customer Satisfaction Survey for the CDC Antibiotic Resistance (AR) Isolate Bank Form and Instruction New
236343 Acceptability Survey of ARI Campaign for University of Utah Pediatric Clinic Champions Form and Instruction New
236079 Immigrant, Refugee, and Migrant Health (IRMH) Website Redesign Form and Instruction New
235788 Survey to evaluate the Nursing Home Infection Preventionist Training Course Form and Instruction New
233228 Dialysis Event Module Training Needs Assessment Form and Instruction New
232787 Customer Satisfaction Survey for 2018 UNGA AMR Side Event Form and Instruction New
232515 Customer Satisfaction Survey for CDC AR Isolate Bank Form and Instruction New
231138 Tuberculosis Education Materials for Classified Immigrants Form and Instruction New
ICR Details
0920-1071 201711-0920-019
Active 201503-0920-011
HHS/CDC 0920-1071
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
Extension without change of a currently approved collection   No
Regular
Approved without change 02/09/2018
Retrieve Notice of Action (NOA) 01/08/2018
  Inventory as of this Action Requested Previously Approved
02/28/2021 36 Months From Approved 06/30/2018
5,800 0 5,800
3,850 0 3,850
0 0 0
This collection of information is necessary to enable the Agency to garner customer and stakeholder feedback in an efficient, timely manner, in accordance with our commitment to improving service delivery. The information collected from our customers and stakeholders will help ensure that users have an effective, efficient, and satisfying experience with the Agency's programs.
EO: EO 12862 Name/Subject of EO: Setting Customer Service Standards
   US Code: 42 USC 241 Name of Law: The Public Health and Welfare
  
None
Not associated with rulemaking
  82 FR 46994 10/10/2017
82 FR 61001 12/26/2017
No
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 5,800 5,800 0 0 0 0
Annual Time Burden (Hours) 3,850 3,850 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$50,000
No
    Yes
    No
No
No
No
Uncollected
Thelma Sims 4046394771
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
01/08/2018