ICR Documents

Supporting Statement A Document Date Uploaded Supporting Statement A 0368.docx 07/07/2014 Supporting Statement B Document Date Uploaded Supporting Statement B.docx 05/14/2014 Supplementary Documents Title Document Document Type Date Uploaded Recruitment Script_At Clinic Recruitment Script_At Clinic.docx Supplementary Document 05/09/2013 Flyer Flyer.doc Supplementary Document 05/09/2013 Handout_English Handout_English.doc Supplementary Document 05/09/2013 2014 Health Center Patient Survey Cognitive Protocol Intro 2014 Health Center Patient Survey Cognitive Protocol Intro.doc Supplementary Document 05/09/2013 Consent forms (3) Consent forms (3).doc Supplementary Document 05/09/2013 Incentive Receipt Incentive Receipt.doc Supplementary Document 05/09/2013 OMB_Korean_materials OMB_Korean_materials.pdf Supplementary Document 04/30/2013 OMB_Chinese_Materials OMB_Chinese_Materials.pdf Supplementary Document 04/30/2013 OMB_Spanish_materials OMB_Spanish_materials.pdf Supplementary Document 04/30/2013 OMB_Vietnamese_materials OMB_Vietnamese_materials.pdf Supplementary Document 04/30/2013 Appendix A - 2006 USC Title 42 Section 254b Appendix A - 2006 USC Title 42 Section 254b.pdf Supplementary Document 04/30/2013 Appendix C Technical Advisory Committee Members Appendix C Technical Advisory Committee Members.docx Supplementary Document 04/30/2013 Appendix B 60Day Federal Notice Appendix B 60Day Federal Notice.pdf Supplementary Document 04/30/2013 Appendix D Data Security Plan Appendix D Data Security Plan.docx Supplementary Document 04/30/2013 Appendix E Critical Incident Form Appendix E Critical Incident Form.docx Supplementary Document 04/30/2013 Results of Pretest Attachment 3 Results of Pretest.pdf Supplementary Document 05/14/2014 Instrument Korean Attachment 2 HCPS Instrument Korean.pdf Supplementary Document 05/14/2014 Instrument Chinese Attachment 2 HCPS Instrument Chinese.pdf Supplementary Document 05/14/2014 Instrument Spanish Attachment 2 HCPS Instrument Spanish.pdf Supplementary Document 05/14/2014 Instrument Vietnamese Attachment 2 HCPS Instrument Vietnamese.pdf Supplementary Document 05/14/2014 Grantee Site Recruitment Materials Attachment 4 Grantee Site Recruitment Materials.pdf Supplementary Document 05/14/2014 Intro & Recruitment Materials Chinese Attachment 4 Introductory and Recruitment Materials for Patients Chinese.pdf Supplementary Document 05/14/2014 Intro & Recruitment Materials Korean Attachment 4 Introductory and Recruitment Materials for Patients Korean .pdf Supplementary Document 05/14/2014 Intro & Recruitment Materials Spanish Attachment 4 Introductory and Recruitment Materials for Patients Spanish.pdf Supplementary Document 05/14/2014 Intro & Recruitment Materials Vietnamese Attachment 4 Introductory and Recruitment Materials for Patients Vietnamese.pdf Supplementary Document 05/14/2014 Consent Form Chinese Attachment 5 Consent Forms Chinese.pdf Supplementary Document 05/14/2014 Consent Form Korean Attachment 5 Consent Forms Korean.pdf Supplementary Document 05/14/2014 Consent Form Spanish Attachment 5 Consent Forms Spanish.pdf Supplementary Document 05/14/2014 Consent Form Vietnamese Attachment 5 Consent Forms Vietnamese.pdf Supplementary Document 05/14/2014 Informed Consent Attachment 5 Informed Consent and Other Procedural Forms.pdf Supplementary Document 05/14/2014 Data Security Plan Data Security Plan.pdf Supplementary Document 05/14/2014 Final Stratification Definition of Final Stratification.pdf Supplementary Document 05/14/2014 Statistical Design Plan Statistical Design Plan.pdf Supplementary Document 05/14/2014 Methodology and Selection Specs Survey Methodology and Selection Specifications.pdf Supplementary Document 05/14/2014 Technical Advisory Committee Members Technical Advisory Committee Members.pdf Supplementary Document 05/14/2014 Regulations USC Title 42 Section 254b.pdf Supplementary Document 05/14/2014 Public Comments Author Name Comment Document Author Affiliation Sponsoring Org. Type Category Date of Comment Date Comment Received