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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Attitudes and Perceptions of People Living with Hepatitis B on Participation in Clinical Trials
Agency IC Tracking Number:
OC
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-Consent form
0497 Attitudes and Perceptions Hep B Clinical Trials Consent Form FINAL 9-8-2022.docx
Yes
Yes
Fillable Fileable Signable
Other-Eligibility Screening Questions
0497 Attitudes and Perceptions Hep B Clinical Trials Eligibility Sceening Questions FINAL 9-8-2022.docx
Yes
Yes
Fillable Fileable
Other-Moderator's Guide
0497 Attitudes and Perceptions Hep B Clinical Trials Moderator Guide FINAL 8-22-2022.docx
Yes
Yes
Fillable Fileable
Other-Recruitment flyer African 1
Generic African 1.png
Yes
No
Printable Only
Other-Recruitment flyer African 2
Generic African 2.png
Yes
No
Printable Only
Other-Recruitment flyer Asian 1
Generic Asian 1.png
Yes
No
Printable Only
Other-Recruitment flyer Asian 2
Generic Asian 2.png
Yes
No
Printable Only
Other-IRB
HIRB approval Cohen HBF 8.22.2022.pdf
Yes
No
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
47
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
47
0
47
0
0
0
Annual IC Time Burden (Hours)
71
0
71
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
OMB Memo - Attitudes and Perceptions of People Living with Hepatitis B on Participation in Clinical Trials
0497 OMB Memo - Attitudes and Perceptions Hep B FINAL 9-13-2022.docx
09/13/2022
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.