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

View Information Collection (IC)

Birth Control Options (Digital and Print Communication Focus Groups) OC OC
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Screener Guide in English Yes No Printable Only
Other-Screener Guide in Spanish Yes No Printable Only
Other-Survey Instrument in English Yes Yes Fillable Fileable
Other-Survey Instrument in Spanish Yes Yes Fillable Fileable
Other-Consent Form in English Yes Yes Fillable Fileable
Other-Consent Form in Spanish Yes Yes Fillable Fileable
Other-Confirmation Letter in English Yes No Printable Only
Other-Confirmation Letter in Spanish Yes No Printable Only
Other-Birth Control Chart in English Yes No Printable Only
Other-Birth Control Chart in Spanish Yes No Printable Only

Health Consumer Health and Safety

 

72 0
   
Individuals or Households
 
   100 %

  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 72 0 72 0 0 0
Annual IC Time Burden (Hours) 108 0 108 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
OMB Approval Memo 09/10/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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