[CPR]NAC Post-visit Survey

[OADC] CDC Usability and Digital Content Testing

Documents and Forms

Document Name Document Type
Form 0920-25-0053 [CPR]NAC Post-visit Survey Form
0920-25-0053 Post-site Survey Post-site Visit Survey_2025_GenICv2.docx Form
0920-10R50-Request-GenIC NAC Post-site Surveyv2.docx GenIC Request IC Document

Information Collection (IC) Details

IC Title:	[CPR]NAC Post-visit Survey	Agency IC Tracking Number:	0920-25-0053

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	0920-25-0053	Post-site Survey	Post-site Visit Survey_2025_GenICv2.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 40	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	40	40
Annual IC Time Burden (Hours)	7	7
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
GenIC Request	0920-10R50-Request-GenIC NAC Post-site Surveyv2.docx	03/19/2025

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