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View Information Collection (IC)

View Information Collection (IC)

Cognitive Interviews for Prescription Drug Module Redesign
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Attachment F-Instrument and Protocol Yes Yes Paper Only

Health Public Health Monitoring

 

240 0
   
Individuals or Households
 
   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 240 0 240 0 0 0
Annual IC Time Burden (Hours) 92 0 92 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Attachment B-Recruitment Screener 11/17/2010
Attachment C-Cover Letter 11/17/2010
Transmittal Memo 11/17/2010
Attachment G-Receipt for Participation 11/17/2010
Supporting Statement 12/17/2010
Cognitive Recruitment Flyer 12/17/2010
Parental Informed Consent Form 12/17/2010
Participant Informed Consent 12/17/2010
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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