Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
CIS Email Intake Form (Appendix 2) New 1000 33 0 Form and Instruction 7 CIS Email Intake Form
CIS LiveHelp Questionnaire (Appendix 1B) Modified 7800 260 0 Form and Instruction 3 CIS LiveHelp Form
CIS Smoking Cessation Proactive Follow-up (Appendix 1D) Modified 4000 67 0 Form and Instruction 6 Smoking Cessation Proactive Follow-Up
CIS Smoking Cessation Reactive Service "Demographic" Questions (Appendix 1C) Modified 1300 43 0 Form and Instruction 5 Smoking Cessation Reactive Service Demographic Questions
CIS Smoking Cessation Reactive Service "Intake" Questions (Appendix 1C) Modified 4200 350 0 Form and Instruction 4 Smoking Cessation Reactive Service Client Questions
CIS Telephone Clients - Demographic Questions (Appendix 1A) Modified 24300 810 0 Form and Instruction 2 Telephone Clients - Demographic Questions
CIS Telephone Customer Service Questions (Appendix 1A) Modified 67400 1123 0 Form and Instruction 1 Telephone Client-Customer Service Questions
Total burden requested under this ICR: 110000 2686 0  
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