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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Parents' Perceptions of Public Service Announcement Concepts on Electronic Nicotine Delivery Systems
Agency IC Tracking Number:
16FS
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
Form
none
Screener
Att 1-Screener 11 23 15.doc
No
Paper Only
Form
none
Moderator's Guide
Att 4-Moderator's Guide 11 20 15.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
270
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
270
0
270
0
0
0
Annual IC Time Burden (Hours)
150
0
150
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
SS Part A
0920-0910_Part A_OSH ENDS Focus Groups 11 20 15.docx
11/24/2015
SS Part B
0920-0910_Part B_OSH ENDS Focus Groups 11 20 15.docx
11/24/2015
Informed Consent
Att 2-Informed Consent doc 11 20 15.doc
11/24/2015
IRB
Att 3 ICF Institutional Review Board Approval.pdf
11/24/2015
Fact Sheet
Attachment 5 ENDS and 2014 SGR Fact Sheet OSH ENDS Focus Groups_lje.pdf
11/24/2015
Confirmation Script
Att 6-Confirmation Script docx 11 20 15.docx
11/24/2015
Material Fact Sheet
Att 7- Smoker Cessation Material Fact Sheet.pdf
11/24/2015
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.