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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
CIS Email Intake Form (Appendix 2_REV)
New
1000
33
0
Form and Instruction
6
Email Intake
CIS LiveHelp Questionnaire (Appendix 1B_REV)
Modified
7800
260
0
Form and Instruction
3
LiveHelp Questionnaire
CIS Smoking Cessation Proactive Follow-ups (Appendix 1D_REV)
Modified
4000
67
0
Instruction
CIS Smoking Cessation Reactive Service "Demographic" Questions (Appendix 1C_REV)
Modified
1300
43
0
Form and Instruction
5
Smoking Cessation Reactive Service Demographic Questions
CIS Smoking Cessation Reactive Service "Intake" Questions (Appendix 1C_REV)
Modified
4200
350
0
Form and Instruction
4
Smoking Cessation Reactive Service Client Questions
CIS Telephone Customer Service Questions (Appendix 1A_REV)
Modified
67400
1123
0
Form and Instruction
1
Telephone Customer Service Questions
CIS Telephone Demographic Questions (Appendix 1A_REV)
Modified
24300
810
0
Form and Instruction
2
Telephone Demographic Questions
Total burden requested under this ICR:
110000
2686
0
To view an IC, click on IC Title