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 LiveHelp Questionnaire (Appendix 1B) Modified 7800 260 0 Form and Instruction 3
CIS Smoking Cessation Proactive Follow-up (Appendix 1D) Modified 4000 67 0 Form and Instruction 6
CIS Smoking Cessation Reactive Service "Demographic" Questions (Appendix 1C) Modified 1300 43 0 Form and Instruction 5
CIS Smoking Cessation Reactive Service "Intake" Questions (Appendix 1C) Modified 4200 350 0 Form and Instruction 4
CIS Telephone Clients - Demographic Questions (Appendix 1A) Modified 24300 810 0 Form and Instruction 2
CIS Telephone Customer Service Questions (Appendix 1A) Modified 67400 1123 0 Form and Instruction 1
Total burden requested under this ICR: 110000 2686 0  
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