View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Provider Feedback for Chlamydia Prevention and Control Online Resources 15GA
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction none Recruitment screener Att1 RecruitmentScreener.docx Yes No Fillable Printable
Instruction Att2 CaseStudyResourceReview.docx Yes No Fillable Printable
Form and Instruction none Moderator's guide Att3 ModeratorGuide.docx Yes No Fillable Printable

Health Consumer Health and Safety

 

52 0
   
Private Sector Businesses or other for-profits
 
   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 52 0 52 0 0 0
Annual IC Time Burden (Hours) 37 0 37 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Request for Approval - screener Generic Clearance for Qualitative Feedback Template Approval Form Screener.docx 01/26/2015
Request for approval - moderator's guide Generic Clearance for Qualitative Feedback Template Approval Form.docx 01/26/2015
Talking points for recruitment NCC_RecruitingTalkingPoints.docx 01/26/2015
Supporting Statements Supporting Statements.docx 01/26/2015
Email EmailContent to Participants.docx 01/26/2015
Recruitment flyer Recruitment announcement.docx 01/26/2015
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.