PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Consent for qualitative interview - Spanish (Att 5d)
Unchanged
50
4
0
Form and Instruction
0920-1402
Attachment 5D SHIELD QUAL Model Consent (Spanish)
Consent for qualitative interview– English (Att 5c)
Unchanged
50
4
0
Form and Instruction
0920-1402
Attachment 5c SHIELD Model Qual Consent (English)
In-depth Interview – English (Att 6c)
Modified
50
75
0
Form and Instruction
0920-1402
Attachment 6C SHIELD Qualitative IDI Guide (English)
In-depth Interview – Spanish (Att 6d)
Unchanged
50
75
0
Form and Instruction
0920-1402
Attachment 6D SHIELD Qualitative IDI Guide (Spanish)
SHIELD Model Consent (English)
Unchanged
2000
167
0
Form and Instruction
0920-1402
Attachment 5A SHIELD Model and Actual Consent (English)
SHIELD Model Consent (Spanish)
Unchanged
500
42
0
Form and Instruction
0920-1402
Attachment 5B SHIELD Model Consent (Spanish)
SHIELD Model Recruitment Script (Spanish)
Unchanged
500
125
0
Form and Instruction
0920-1402
Attachment 4b SHIELD Quantitative Recruitment Script (Spanish)
SHIELD Recruitment Script (English)
Unchanged
2000
500
0
Form and Instruction
0920-1402
Attachment 4a SHIELD Quantitative Recruitment Script (English)
SHIELD Survey (English)
Modified
2000
1666
0
Form and Instruction
0920-1402
Attachment 6A SHIELD Survey (English)
SHIELD Survey (Spanish)
Modified
500
416
0
Form and Instruction
0920-1402
Attachment 6B SHIELD Survey SPANISH
Total burden requested under this ICR:
7700
3074
0
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