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

View Information Collection (IC)

National Tobacco Education Campaign: Creative Concept Testing 17QV
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction NA Recruitment Screener for Online Questionnaire Att 2 - Online Questionnaire Recruitment Screener_V2_CLEAN COPY.DOCX NA Yes Yes Fillable Fileable
Form and Instruction NA Online Questionnaire Att3-Online Questionnaire Main.docx NA Yes Yes Fillable Fileable
Form and Instruction NA Focus Group Screener Att 4 - Focus Group Recruitment Screener (Telephone Screener)_12 21 16_C....docx NA Yes Yes Fillable Fileable
Form and Instruction NA Pre-Focus Group Questionnaire and Informed Consent Att 5 - Pre-Focus Group Questionnaire and Informed Consent_1 13 17.docx NA No   Paper Only
Form and Instruction NA Focus Group Moderator Guide - Exclusive Smokers Att 6 - Focus Group Moderator's Guide - Exclusive Smokers_1 13 17.docx NA No   Paper Only
Form and Instruction NA Focus Group Moderator Guide - Dual User Att 7 - Focus Group Moderator's Guide - Dual Users_1 13 17.docx NA No   Paper Only
Form and Instruction NA Participant Feedback Questionnaire Att 8 - Participant Feedback Questionnaire_12 21 16_CLEAN.DOCX NA No   Paper Only

Health Public Health Monitoring

 

27,692 0
   
Individuals or Households
 
   85 %

  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 27,692 0 27,692 0 0 0
Annual IC Time Burden (Hours) 3,109 0 3,109 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Online Questionnaire Email Invitation Att 1 - Online Questionnaire Email Invitation to Potential Respondents.docx 05/05/2017
Toluna USA Membership Site - Terms and Conditions Att 9 - Toluna Terms and Conditions_NO CHANGE.DOCX 05/05/2017
IRB Approval - Battelle Att 10 - IRB Approval.pdf 05/05/2017
Toluna USA - Privacy Policy Att 11 - Toluna Privacy Policy.docx 05/05/2017
Schlesinger Associates - Privacy Policy Att 12 - Schlesinger Privacy Policy.docx 05/05/2017
Supporting Statement A - 05MAY2017 Part A - Creative Concepts_05MAY2017.docx 05/05/2017
Supporting Statement B - 05MAY2017 Part B - Creative Concepts_05MAY2017.docx 05/05/2017
Creative Concept Testing - Secure Website Link Creative Concept Testing - Secure Website Link.docx 05/05/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.