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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Consumer perceptions as a foundation for CTP positioning initiative
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
Other-Adolescent Screener
CTP Positioning DOC 03_Adolescent Screener.doc
Yes
No
Paper Only
Other-Adult Screener
CTP Positioning DOC 04_Adult Screener.doc
Yes
No
Paper Only
Other-Adolescent Assent Form
CTP Positioning DOC 05_Adolescent Assent Form.doc
Yes
No
Paper Only
Other-Adult Informed Consent
CTP Positioning DOC 06_Adult Informed Consent.doc
Yes
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Immunization Management
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
64
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
64
0
0
0
0
0
Annual IC Time Burden (Hours)
128
0
0
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
OMB Justification Memo
CTP Positioning DOC 01_Generic Clearance Memorandum.doc
03/14/2012
CTP Positioning DOC 02_Focus Group Composition
CTP Positioning DOC 02_Focus Group Composition.doc
03/14/2012
CTP Positioning DOC 07_Adolescent Moderators Guide
CTP Positioning DOC 07_Adolescent Moderators Guide.doc
03/14/2012
CTP Positioning DOC 08_Adult Moderators Guide
CTP Positioning DOC 08_Adult Moderators Guide.doc
03/14/2012
CTP Positioning DOC 09_CTP Description
CTP Positioning DOC 09_CTP Description.doc
03/14/2012
CTP Positioning DOC 10_Territory Stimuli
CTP Positioning DOC 10_Territory Stimuli.pptx
03/14/2012
CTP Positioning DOC 11_Interbrand Nondisclosure Agreement
CTP Positioning DOC 11_Interbrand Nondisclosure Agreement.pdf
03/14/2012
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.