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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
An Assessment of Rural and Uninsured Consumer Perspectives on Cancer and Related Communications: A Focus Group Study (Sub-Study #16)
Agency IC Tracking Number:
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
2A
Moderator's Guide_No Cancer_Sub-study #16
Attach B_Mod Guide_NO Cancer Exp_NCI Rural_Insurance FGs 7 15 09.doc
Yes
Yes
Printable Only
Form and Instruction
2B
Moderator's Guide_With Cancer_Sub-study #16
Attach C_Mod Guide_WITH Cancer Exp_NCI Rural_Insurance FGs 7 15 09.doc
Yes
Yes
Printable Only
Form and Instruction
1
Screener_Sub-study #16
Attach A_Screener_Rural and Insurance Status Focus Groups 7 23 09.doc
Yes
Yes
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
192
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
192
0
0
0
0
0
Annual IC Time Burden (Hours)
480
0
0
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Research Design
Attach D_ Research Design_NCI Rural_Insurance FGs.docx
07/15/2009
GC Summary Form
GC Sub-Study Summary Form_0925-0046-16.doc
07/15/2009
Recruitment Charts
Attach E_Recruitment Charts_NCI Rural_Insurance FGs.docx
07/15/2009
Justification Memo Sub-Study #16
Justification Memo Rural and Uninsured Focus Groups_ 7 15 09.doc
07/23/2009
REVISED FINAL_ Justification Memo Rural and Uninsured Focus Groups-10_16_09
REVISED FINAL_ Justification Memo Rural and Uninsured Focus Groups-10_16_09.docx
10/16/2009
Attach F_Informed Consent Rural and Uninsured Consumer
Attach F_Informed Consent Rural and Uninsured Consumer.docx
10/16/2009
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.