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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Formative Assessment of the Information Needs to Prevent Skin Cancer Among Spanish speaking Outdoor Workers
Agency IC Tracking Number:
0920-1154-20BF
IC Status:
New
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-Focus Group Guide
Focus Group Guide - English_Spanish 10-29-19.docx
Yes
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
28
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
28
0
28
0
0
0
Annual IC Time Burden (Hours)
42
0
42
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Request for Approval
GenICRequest_Focus groups_Skin_Cancer_110619.docx
11/06/2019
Supporting Statement A
Statement A_110519 Clean.docx
11/06/2019
Supporting Statement B
Statement B_110419Clean.docx
11/06/2019
Consent
Recruitment_Consent_Form_English_Spanish 102919.docx
11/06/2019
Research Determination
Att II. DSI IRB_Nonresearch_Flynn_Skin Cancer Outdoor Workers_2019 Aug 30.pdf
11/06/2019
Authorizing legislation
Att I. OSH Act.doc
11/06/2019
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.