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

View Information Collection (IC)

Feasibility Study for a MEPS Monthly Check-In
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1B Attachment 1-B. Study 1 Recruitment screener 1B Study 1 Recruitment Screener.docx Yes Yes Fillable Fileable
Form and Instruction 1C Attachment 1-B. Study 1 Recruitment screener 1C Study 1 Recruitment Script.docx Yes Yes Fillable Fileable
Form and Instruction 1F Attachment 1-F. Study 1 MCI Protocol 1 1F Study 1 Protocol 1 (MCI-1).docx Yes Yes Fillable Fileable
Form and Instruction 1G Attachment 1-G. Study 1 MCI Protocol 2 1G Study 1 Protocol 2 (MCI-2).docx Yes Yes Fillable Fileable
Form and Instruction 1H Attachment 1-H. Study 1 Protocol 3 (R2) 1H Study 1 Protocol 3 (R2).docx Yes Yes Fillable Fileable
Form and Instruction 1I Attachment 1-I. Study 1 MEPS Abbreviated R2 Interview 1I Study 1 R2_instrument.docx Yes Yes Fillable Fileable
Form and Instruction 2B Attachment 2-B. Study 2 Recruitment telephone script + scheduling MCI interview 2B - Study 2 Recruitment Script.docx Yes Yes Fillable Fileable
Form and Instruction 2E Attachment 2-E. Study 2 MCI Protocol 2E - Study 2 MCI Protocol.docx Yes Yes Fillable Fileable
Instruction 2F - Study 2 FG Guide.docx No   Paper Only
Instruction 1A Study 1 Ad.docx No   Printable Only

Health Public Health Monitoring

 

195 0
   
Individuals or Households
 
   50 %

  Requested 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 195 0 0 0 0 195
Annual IC Time Burden (Hours) 90 0 0 0 0 90
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Cover Letter OMB Cover Letter.docx 02/11/2022
Attachment 1-D. Study 1 Consent form 1D Study 1 Informed Consent.docx 03/07/2022
Attachment 1-E. Study 1 Zoom instructions 1E Study 1 Zoom_instructions.docx 02/11/2022
Attachment 2-A. Study 2 Recruitment letter 2A - Study 2 Recruitment Letter.docx 03/07/2022
Attachment 2-C. Study 2 Consent form 2C - Study 2 InformedConsent.docx 03/07/2022
Attachment 2-D. Study 2 Zoom instructions 2D - Study 2 Zoom_instructions.docx 02/11/2022
Supporting Statement Part A MCI Statement A.docx 02/11/2022
Supporting Statement Part B MCI Statement B_OMB_updated.docx 03/07/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.