ICR Documents

Supporting Statement A Document Date Uploaded SSA_mChoice_clean.docx 11/06/2024 Supporting Statement B Document Date Uploaded SSB mChoice_clean.docx 11/06/2024 Supplementary Documents Title Document Document Type Date Uploaded Authorizing Legislation Att 1_Auth Legislation.docx Supplementary Document 11/15/2023 60 Day FRN Att 2a_60-day FRN Pub 6_13_2022.pdf Supplementary Document 02/14/2024 Patient Recruitment Materials Att 3a_Patient Recruitment Materials English.docx Supplementary Document 02/14/2024 Patient Recruitment Materials (Spanish) Att 3a_Patient Recruitment Materials Spanish.docx Supplementary Document 02/14/2024 Provider Recruitment Materials Att 3b_Provider Recruitment Materials.docx Supplementary Document 02/14/2024 Patient Consent to Screen Att 5a_Patient Consent to Screen_CLEAN.pdf Supplementary Document 02/14/2024 Patient Consent to Screen (Spanish) Att 5a_Patient Consent to Screen Spanish.pdf Supplementary Document 02/14/2024 Patient Consent Form Att 5b_Patient Consent Form English.pdf Supplementary Document 02/14/2024 Patient Consent Form (Spanish) Att 5b_Patient Consent Form Spanish.pdf Supplementary Document 02/14/2024 Patient Interview Consent Form Att 5c_Patient Interview Consent Form English.pdf Supplementary Document 02/14/2024 Patient Interview Consent Form (Spanish) Att 5c_Patient Interview Consent Form Spanish.pdf Supplementary Document 02/14/2024 Provider Consent to Screen Att 5d_Provider Consent to Screen.pdf Supplementary Document 02/14/2024 Provider Consent Form Att 5e_Provider Consent Form.pdf Supplementary Document 02/14/2024 Columbia University IRB Approval Att 6a_Columbia University IRB approval.pdf Supplementary Document 02/14/2024 UAB IRB Reliance Agreement Att 6b_University of Alabama at Birmingham IRB reliance agreement.pdf Supplementary Document 02/14/2024 Callen Lorde IRB Reliance Agreement Att 6d_Callen_Lorde IRB reliance agreement.pdf Supplementary Document 02/14/2024 Data Use Plan Att 7_Data Use Plan mChoice.docx Supplementary Document 02/14/2024 PIA Att 8_Privacy Impact Assessment_mChoice.pdf Supplementary Document 02/14/2024 Provider Training Summary Att 9_Provider Training Summary.docx Supplementary Document 02/14/2024 NonSubstantive Change Request Justification mChoice_summary of changes memo_011024.docx Justification for No Material/Nonsubstantive Change 02/14/2024 Change Request mChoice 0920-1428 Justification and Summary of Changes.docx Justification for No Material/Nonsubstantive Change 11/06/2024 Public Comments Author Name Comment Document Author Affiliation Sponsoring Org. Type Category Date of Comment Date Comment Received