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

View Information Collection (IC)

BRFSS Preliminary Experiment for Sample and Mode
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-WORD Yes No Fillable Printable

Health Consumer Health and Safety

 

13,500 0
   
Individuals or Households
 
   33 %

  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 13,500 0 13,500 0 0 0
Annual IC Time Burden (Hours) 3,375 0 3,375 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Att 1_BRFSS Data Collection Protocols 08/16/2017
Att 2_Telephone Interviewer's Inform Consent 08/16/2017
Att 3_Lanaguage for Informed Consent in Mailed Survey 08/16/2017
Att 5_Letter of Invitation (Web based Participants) 08/16/2017
Request for genIC Approval 08/16/2017
Sup Stmt Part A 09/11/2017
Sup Stmt Part B 09/11/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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