Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Follow-up for Callers who Received a Quitline Service Unchanged 28900 3372 0 Form and Instruction F1 NQDW 7-Month Follow-Up Questionnaire
Instructions for submitting caller intake and follow up Unchanged 53 53 0 Instruction
Intake Information for Callers who Contact the Quitline for Personal Use Unchanged 510768 85128 0 Form and Instruction E1(a) NQDW Intake Questionnaire
Intake Information for Callers who Contact the Quitline for Someone Else Unchanged 24688 411 0 Form and Instruction E1(b) NQDW Intake Questionnaire Subset Final
Quitline Services Questionnaire Modified 212 71 0 Form none Quitline Services Survey
Total burden requested under this ICR: 564621 89035 0  
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