View Information Collection (IC)
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Healthy People 2020 Consortium Member Assessment to Support the US DHHS
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0990-0281 Focus Group and Interview recruitment Screener 0990-0281Focus Group and Interview Screening Instrument 2009-17-09 (2).rtf Yes No Printable Only
Form 0990-0281 Interviewer's Guide 0990-0281Interview Guide 2009-17-09 (2).rtf Yes Yes Paper Only
Form 0990-0281 Moderator's Guide 0990-0281Focus Group Guide 2009-17-09 (2).rtf Yes Yes Printable Only
Form 0990-0281 Healthy People 2020 Consortium Member Assessment 0990-0281Healthy People 2020 Consortium Member Assessment 2009-17-09 (2).doc Yes Yes Printable Only

Health Illness Prevention

 

168 0
   
State, Local, and Tribal Governments
 
   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 168 0 0 0 0 0
Annual IC Time Burden (Hours) 86 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Statement of Need OMB Memo 0990-0281 #2 2009-12-14.doc 12/17/2009
Timeline memo 0990-0281OMB Timeline memo.pdf 12/17/2009
Consent Form HP2020 Consortium Assessment Consent 2010-01-28.docx 02/19/2010
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.