Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Interview Guide New 120 84 0 Form and Instruction CMS-10816 Informed Consent
Form and Instruction CMS-10816 Cognitive Interview Protocol
Invitation & Screening New 350 30 0 Form and Instruction CMS-10816 Recruitment Script
Form and Instruction CMS-10816 Eligibility Screener Questionnaire
Total burden requested under this ICR: 470 114 0  
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