Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
ASQ Intake Questionnaire (Chinese, Korean, Vietnamese - Subset) Unchanged 249 4 112 Form and Instruction None
Form and Instruction None
Form and Instruction None
Asian Smokers Quitline (ASQ) Intake Questionnaire (Complete Chinese, Korean, Vietnamese) Unchanged 1686 281 7598 Form and Instruction None
Form and Instruction None
Form and Instruction None
Asian Smokers Quitline (ASQ) Seven-Month Follow-Up Questionnaire Unchanged 236 28 744 Form and Instruction None
Form and Instruction None
Form and Instruction None
Form and Instruction None
NQDW Intake Questionnaire (English complete) - Callers who contact Quitline for themselves Modified 405053 67509 1825412 Form and Instruction None
NQDW Intake Questionnaire (English subset) - Callers who contact Quitline on behalf of someone else Unchanged 819 14 369 Form and Instruction None
NQDW Quitline Services Survey Unchanged 108 36 973 Form and Instruction None
Submission of NQDW ASQ Seven-Month Follow-Up Electronic Data File Unchanged 1 1 27 Instruction
Submission of NQDW Intake Questionnaire Electronic Data File Unchanged 216 216 5841 Instruction
Total burden requested under this ICR: 408368 68089 1841076  
To view an IC, click on IC Title