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Bundled Sub-studies #5 (Focus Groups) and #6 (Survey) to Test Messages and Raise Public Awareness about NIH Clinical Trials
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 #5 Moderators Guide and Screener #5_Attach 5A Mod guide & 5B Screener_CT Campaign_2010-11-5.docx Yes No Printable Only
Form and Instruction 2 #6 Web-based Survey #6_Attach 6B _CT Survey.doc Yes Yes Fillable Fileable

Health Public Health Monitoring

09-25-0156, Records of Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public Health Service, HHS/PHS/NIH/OD  67 FR 60743

846 150
   
Individuals or Households
 
   71 %

  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 846 0 0 0 0 0
Annual IC Time Burden (Hours) 368 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Combined Generic Sub-study Form #5 and #6 Combined GS Form_0925-0046-5 & -6.doc 11/09/2010
Memo Key to Bundled Sub-studies #5 and #6 Memo to OMB_Key To Bundled Pkg.doc 11/09/2010
#6 Justif Memo & Attach 6A Invite and 6C Consent #6_Justif Memo, Attach 6A Invite & 6C Consent_CT Survey_2010-11-9.docx 11/09/2010
#5 Justif Memo and 5C Consent #5_Justif Memo & Attach 5B Consent_CT Campaign_2010-11-9.docx 11/09/2010
Revised #5 Just Memo #5_REV_Justif Memo & Attach 5C Consent_CT Campaign_2010-12-15.docx 12/22/2010
Revised #6 JustMemo #6_REV_Justif Memo, Attach 6A Invite & 6C Consent_CT Survey_2010-12-15.docx 12/22/2010
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.