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

View Information Collection (IC)

Alcohol Information Audience Needs Assessment (NIAAA)
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Online survey Screener and consent form Attachment A NIAAA Formative Research Online Survey_Screener and Consent Form_101521_revised.docx No   Paper Only
Form 2 Online survey Attachment B - NIAAA Formative Research_Online Survey Instrument_10-15-21.docx Yes Yes Fillable Fileable
Form and Instruction 3 Focus Group Screener Attachment C - Focus Group Screener_10-15-21.docx No   Paper Only
Form and Instruction 4 Focus Group Consent Form Attachment D - Focus Group Consent Form_10-15-21.docx Yes Yes Fillable Fileable
Instruction Attachment E - Focus Group Moderator Guide _10-15-21.docx No   Paper Only

Health Health Care Services

09-25-0156; “Records of Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public Health Service, HHS/PHS/NIH/OD  67 FR 67042

2,424 0
   
Individuals or Households
 
   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 2,424 0 2,424 0 0 0
Annual IC Time Burden (Hours) 646 0 646 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Mini SSA Mini SSA - Alcohol Information Audience Needs Assessment_10-15-21_revised.docx 10/28/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.