View Information Collection (IC)

View Information Collection (IC)

NIOSH Virtual Cognitive Interview Study 0920-0222-20SJ
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction none Telephone screener Att 4ab - NIOSH Virtual Telephone Screener.docx Yes Yes Fillable Fileable
Form and Instruction none NIOSH questionnaire Att 2 NIOSH Virtual Questionnaire 2-24-2020.docx Yes Yes Fillable Fileable
Form and Instruction none Respondent data sheet Att 6ab - NIOSH Virtual Respondent Data Sheet.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

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

90 0
   
Individuals or Households
 
   100 %

  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 90 0 90 0 0 0
Annual IC Time Burden (Hours) 31 0 31 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
NIOSH response to OMB questions Att 1 - NIOSH Response to Qs- 2-24-2020.docx 09/30/2020
Advertisement flyer Att 3ab - NIOSH Virtual AdFlyer.docx 09/30/2020
Consent Att 5ab - NIOSH Virtual Informed Consent.docx 09/30/2020
Thank you letter Att 7 NIOSH Virtual Thank You Letter.docx 09/30/2020
Letter of request 10-day letter_NIOSH Virtual_Sept 30 2020-CLEAN.docx 10/01/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.