ICR Documents

Supporting Statement A Document Date Uploaded Supp Statement A 060815.docx 06/11/2015 Supporting Statement B Document Date Uploaded Supp Statement B 052815.doc 06/11/2015 Supplementary Documents Title Document Document Type Date Uploaded Authorizing Legislation Att A Pub Health Serv Act.doc Supplementary Document 06/11/2015 Published 60-day FRN Attach B 60day Fed Reg Notice.pdf Supplementary Document 06/11/2015 Nondisclosure Affidavit Att C nondisclosure affidavit.doc Supplementary Document 06/11/2015 Sample Screening Script Att D screening script.doc Supplementary Document 06/11/2015 Informed Consent Templates for Interviews Att E informed consent.doc Supplementary Document 06/11/2015 Special Consent for Expanded Use of Video/Audio Att F Spec consent.docx Supplementary Document 06/11/2015 Special Consent to Send Video/Audio Off-site Att G Spec consent 4offsite research.doc Supplementary Document 06/11/2015 Special Consent for Expanded use Video/Audio Discussion Groups Att H Spec consent for fg.docx Supplementary Document 06/11/2015 IRB Approval Documentation Att I IRB approval.rtf Supplementary Document 06/11/2015 Sample Recruitment Flyer Att J Sample flyer.doc Supplementary Document 06/11/2015 Sample Newspaper Advertisement Att K Sample newspaper adv.doc Supplementary Document 06/11/2015 Sample Voice Mail Script Att L QDRL Voice mail script.doc Supplementary Document 06/11/2015 Sample 2014 Advance Letter sent to Respondents Att M Sample advance letter.doc Supplementary Document 06/11/2015 Respondent Data Collection Sheet Att N Resp data collect sheet.doc Supplementary Document 06/11/2015 Cognitive Interview Procedure Read to Respondent Att O Explain cog interview.doc Supplementary Document 06/11/2015 Public Comments Author Name Comment Document Author Affiliation Sponsoring Org. Type Category Date of Comment Date Comment Received