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Agenda
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
Appendix E_screening questionnaire.docx
Yes
Yes
Fillable Fileable
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:
400
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
400
0
0
0
0
400
Annual IC Time Burden (Hours)
872
0
0
0
0
872
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Reminder Call Script
Appendix H_Reminder Call Script_final 5-26-20.docx
05/27/2020
Recruit Call Script
Appendix F_Recruit Call Script__COVID.docx
08/06/2020
Confirmation Email
Appendix G_Confirmation Email__COVID.docx
08/06/2020
IRB Approval
Appendix K_IRB_Approval_COVID.docx
08/06/2020
Day of Screening
Appendix N_day of screening tool_COVID.docx
08/06/2020
Study Design
Appendix A_study design_Yr 5.docx
03/04/2022
Recruiting Ads
Appendix B_recruiting ads.docx
03/04/2022
Recruiting Email
Appendix C_Recruiting Email.docx
03/04/2022
Recruiting Sign
Appendix D_recruiting sign.docx
03/04/2022
Consent Form
Appendix J_consent_form.docx
03/04/2022
Instructions and Recipes
Appendix L_instructions_and_recipes.docx
03/04/2022
Additional COVID procedures
Appendix M_additional_COVID procedures.docx
03/04/2022
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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