Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Instrument 12a: COVID-19 Cohort STS Modified 1702 1702 0 Other-Survey
Instrument 12b: HPOG 2.0 National Evaluation Intermediate Follow-up COVID-19 Cohort Short-term Survey – Critical Items Only New 172 57 0 Other-Survey
Instrument 18: Intermediate Follow-up Survey for the National Evaluation impact study Removed 0 0 0 Other-Survey
Instrument 18a: Intermediate Follow-up Survey for the National Evaluation impact study - Critical Items Only Removed 0 0 0 Other-Survey
Instrument 5a: HPOG 2.0 National Evaluation Welcome to the Study Packet Modified 167 17 0 Other-Welcome Packet
Instrument 5b: HPOG 2.0 National Evaluation letter and participant contact update form Unchanged 5236 524 0 Other-Update Form
Other-Update Form - Phone Version
PAGES Grantee- and Participant-Level Data Collection (all grantees) Modified 21 677 0 Other-Data collection System
PAGES Participant-Level Baseline Data Collection (participants at Tribal grantees) Removed 0 0 0 Other-Data collection System
PAGES Participant-Level Baseline Data Collection (participants at non-Tribal grantees participating in impact study) Removed 0 0 0 Other-Data collection System
Total burden requested under this ICR: 7298 2977 0  
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