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Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
In-Home Food Safety Behaviors and Consumer Education: Annual Observational Study
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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-screening questionnaire year 3
Appendix E_Screening Questionnaires__final_4_2_19.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1,999
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
1,999
0
0
0
0
1,999
Annual IC Time Burden (Hours)
2,942
0
0
0
0
2,942
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Study Design Year 3
Appendix A_study design_Yr 3_NRTE_3_15_19.docx
04/03/2019
Recruiting Ad
Appendix B_recruiting ad_text_final_4_2_19.pdf
04/03/2019
Recruiting Email
Appendix C_Recruiting Email_final_4_2_19.docx
04/03/2019
Recruiting Sign
Appendix D_Recruiting Sign_final_4_2_19.docx
04/03/2019
Recruiting Call Script
Appendix F_Recruit Call Script__final_3_15_19.docx
04/03/2019
Confirmation Email
Appendix G_Confirmation Email__final_3_15_19.docx
04/03/2019
Reminder Call Script
Appendix H_Reminder Call Script__final_3_15_19.docx
04/03/2019
Informed Consent Year 3
Appendix J_Informed Consent_final_4_4_19.docx
04/04/2019
Recipes and Instructions Year 3
Appendix K_Recipes and Instructions__final_4_4_19.docx
04/04/2019
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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