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genIC Cancer Survivorship Needs Assessment for NCCCProgram Grantees 16BAE
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-WORD Attachment A_Cancer Survivorship Needs Assessment Instrument_Word Version.docx Yes Yes Paper Only
Other-Web Version Attachment B_Cancer Survivorship Needs Assessment Instrument_Web Version.docx Yes Yes Fillable Printable
Other-WORD Attachment C_Telephone Focus Group Interview Guide_Health Care Professional Audience.docx No   Paper Only
Other-WORD Attachment D_Telephone Focus Group Interview Guide_Cancer Survivor and Caregiver Audience.docx No   Paper Only
Other-WORD Attachment E_Telephone Focus Group Interview Guide_Policy and Advocacy Audience.docx No   Printable Only

Health Health Care Services

 

65 0
   
State, Local, and Tribal Governments
 
   100 %

  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 65 0 65 0 0 0
Annual IC Time Burden (Hours) 87 0 87 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SupSta A NCCCP-EVAL-SSA.docx 08/15/2016
SupSta B NCCCP-EVAL-SSB.docx 08/15/2016
Att F_Advanced Email to NCCP Program Directors Attachment F_Web-based Assessment Advanced Notification Email.docx 08/15/2016
Att G_NCCP Grantee Invitation Email Attachment G_Web-based Assessment Invitation Email.docx 08/15/2016
Att H_Reminder Email _ NCCCP Grantee Attachment H_Web-based Assessment Reminder Email.docx 08/15/2016
Att I_Reminder Phone Script Attachment I_Web-based Assessment Reminder Phone Script.docx 08/15/2016
Att J_Telphone Focus Group Recruitment Email Attachment J_Telephone Focus Group Recruitment Email.docx 08/15/2016
Att K_ Telephone Focus Group Confirmation Email Attachment K_Telephone Focus Group Confirmation Email.docx 08/15/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.