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Field Test Survey

ICR 201609-0920-009 · OMB 0920-1061 · Object 68213701.

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-1061 can be found here:

2025-12-10 - No material or nonsubstantive change to a currently approved collection
2024-12-04 - Revision of a currently approved collection

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Attachment 13. Field Test Supplement

The current Revision ICR provides the justification for an annual field test and adds capacity (respondents and burden hours) to support the field test.

After approval of the Revision, CDC plans to upload detailed plans through the Change Request mechanism. The Change Request will include

the screening instrument for field test respondents,
the survey instrument for field tests respondents, and
an updated version of Attachment 13 with additional information.

File Type	application/vnd.openxmlformats-officedocument.wordprocessingml.document
File Title	Field Test Survey
Author	CDC User
File Modified	0000-00-00
File Created	2021-01-23