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

View Information Collection (IC)

Hispanic, Black and Pacific Islander Perspectives on COVID-19 Outreach Strategies and Patient Centered Outcomes (HeAR US)) OC
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Focus Group Questionnaire (ENGLISH) Yes Yes Fillable Fileable
Other-Focus Group Questionnaire (SPANISH) Yes Yes Fillable Fileable
Other-Focus Group Moderator Interview Guide (ENGLISH) No   Printable Only
Other-Focus Group Moderator Interview Guide (SPANISH) No   Printable Only
Other-Recruitment Script Phone (ENGLISH) No   Printable Only
Other-Recruitment Script Phone (SPANISH) No   Printable Only
Other-Recruitment Script Email (ENGLISH) Yes No Printable Only
Other-Recruitment Script Email (SPANISH) Yes No Printable Only
Other-Informed Consent (ENGLISH) Yes No Printable Only
Other-Informed Consent (SPANISH) Yes No Printable Only
Other-Study Flyer (ENGLISH) No   Printable Only
Other-Study Flyer (SPANISH) No   Printable Only
Other-FDA graphics for use with Moderator Guide (ENGLISH) Yes No Printable Only
Other-FDA graphics for use with Moderator Guide (SPANISH) Yes No Printable Only

Health Consumer Health and Safety

 

120 0
   
Individuals or Households
 
   20 %

  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 165 0 165 0 0 0
Annual IC Time Burden (Hours) 248 0 248 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
OMB Memo 12/08/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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