View Information Collection (IC)
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 Instrument and Protocol Attachment F_RxDrugs_Cognitive Protocol_2010_Nov8.doc 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 Attachment B Cognitive Recruitment Screener_2010_Oct.docm 11/17/2010
Attachment C-Cover Letter Attachment C Cover Letter_2010_4_23.docm 11/17/2010
Transmittal Memo PD OMB Memo.doc 11/17/2010
Attachment G-Receipt for Participation Attachment G Cognitive Receipt for Participation_2010_4_23.docm 11/17/2010
Supporting Statement BTDB_PD_OMB_SS_final_12_16.doc 12/17/2010
Cognitive Recruitment Flyer Attachment_A_Cognitive_Recruitment_Flyers_12_16.doc 12/17/2010
Parental Informed Consent Form Attachment_D_-_Parental_Informed_Consent_Form_12_16.doc 12/17/2010
Participant Informed Consent Attachment_E_Participant_Informed_Consent_12_16.doc 12/17/2010
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.