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[NCZEID] Focus Groups and In-Depth Interviews with Travelers and Travel Medicine Specialists
[OS] CDC/ATSDR Formative Research and Tool Development
OMB: 0920-1154
IC ID: 270207
OMB.report
HHS/CDC
OMB 0920-1154
ICR 202506-0920-010
IC 270207
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1154 can be found here:
2025-07-03 - No material or nonsubstantive change to a currently approved collection
2025-07-01 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form 0920-24ID
[NCZEID] Focus Groups and In-Depth Interviews with Travelers and Travel Medicine Specialists
Form
0920-24ID Recruitment Screener
Attch 1 - Intl Travelers - Screener - English 08 08 2024.docx
Form
0920-24ID Consent Form
Attch 2 - Intl Travelers - Consent Form - English 08 08 2024.docx
Form
0920-24ID Focus Group Guide
Attch 3 - Intl Travelers - Focus Group Guide - English 08 08 2024.docx
Form
0920-24ID Interview Recruitment Screener
Attch 7 - Travel Med Specialists - Screener_08 08 2024.docx
Form
0920-24ID Travel Med Specialists - Consent Form
Attch 8 - Travel Med Specialists - Consent Form 08 08 2024.docx
Form
0920-24ID Travel Med Specialists - Interview Guide
Attch 9 - Travel Med Specialists - IDI Guide 08 08 2024.docx
Form
Attch 4 - Intl Travelers - Screener - Spanish 08 08 2024.docx
Recruitment Screener_ Spanish
IC Document
Attch 5 - Intl Travelers - Consent Form - Spanish 08 08 2024.docx
Consent Form_ Spanish
IC Document
Attch 5 - Intl Travelers - Consent Form - Spanish 08 08 2024.docx
Consent Form - Spanish
IC Document
Attch 10- Human Subjects Determination.pdf
Human Subjects Determination
IC Document
GenIC Request Form 08 08 2024.docx
MEMO_ GenIC
IC Document
Supporting Statement A 8 08 2024.docx
SSA
IC Document
Supporting Statement B 08 08 2024.docx
SSB
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
[NCZEID] Focus Groups and In-Depth Interviews with Travelers and Travel Medicine Specialists
Agency IC Tracking Number:
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
0920-24ID
Recruitment Screener
Attch 1 - Intl Travelers - Screener - English 08 08 2024.docx
Yes
Yes
Fillable Fileable
Form
0920-24ID
Consent Form
Attch 2 - Intl Travelers - Consent Form - English 08 08 2024.docx
Yes
Yes
Fillable Fileable
Form
0920-24ID
Focus Group Guide
Attch 3 - Intl Travelers - Focus Group Guide - English 08 08 2024.docx
Yes
Yes
Fillable Fileable
Form
0920-24ID
Interview Recruitment Screener
Attch 7 - Travel Med Specialists - Screener_08 08 2024.docx
Yes
Yes
Fillable Fileable
Form
0920-24ID
Travel Med Specialists - Consent Form
Attch 8 - Travel Med Specialists - Consent Form 08 08 2024.docx
Yes
Yes
Fillable Fileable
Form
0920-24ID
Travel Med Specialists - Interview Guide
Attch 9 - Travel Med Specialists - IDI Guide 08 08 2024.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
672
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
672
0
0
0
0
672
Annual IC Time Burden (Hours)
132
0
0
0
0
132
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Recruitment Screener_ Spanish
Attch 4 - Intl Travelers - Screener - Spanish 08 08 2024.docx
08/16/2024
Consent Form_ Spanish
Attch 5 - Intl Travelers - Consent Form - Spanish 08 08 2024.docx
08/16/2024
Consent Form - Spanish
Attch 5 - Intl Travelers - Consent Form - Spanish 08 08 2024.docx
08/16/2024
Human Subjects Determination
Attch 10- Human Subjects Determination.pdf
08/16/2024
MEMO_ GenIC
GenIC Request Form 08 08 2024.docx
08/16/2024
SSA
Supporting Statement A 8 08 2024.docx
08/16/2024
SSB
Supporting Statement B 08 08 2024.docx
08/16/2024
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.