View Information Collection (IC)

View Information Collection (IC)

Cognitive Interviewing Study of Opioid-Related Questions (Spanish Version) 0920-18AHJ
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a Sample screening script for respondent contact Cognitive interviewing study of opioid use and pain questions Attach 3 Spanish Telephone Screener 051518.docx No   Paper Only
Form and Instruction n/a Spanish Questions to be cognitively tested Attach 1 Spanish Questionnaire.doc No   Paper Only
Form and Instruction n/a Spanish Respondent Data Collection Sheet Attach 5 Spanish Resp Data Collect.docx No   Paper Only

Health Public Health Monitoring

Health and Demographic Surveys Conducted in Probability Samples of the U. S. Population 09-20-0164  49 FR 37693

96 0
   
Individuals or Households
 
   0 %

  Approved 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 96 0 96 0 0 0
Annual IC Time Burden (Hours) 68 0 68 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Project Description (10-day Letter) Spanish Opioid 10-day 051518.docx 05/17/2018
Recruitment Ad for Spanish Speaking Participants Attach 2 Spanish Advertisement.docx 05/17/2018
Informed Consent Form for Spansih Study Attach 4 Spanish Informed Consent.docx 05/17/2018
Thank You Letter Attach 6 Spanish Thank You Letter.docx 05/17/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.