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The Real Cost Campaign Outcomes Evaluation Study: Cohort 3
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-ENGLISH Postcards No   Paper Only
Other-SPANISH Postcards No   Paper Only
Other-ENGLISH : Initial Lead Letter ExPECTT_Baseline (Baseline and Follow-up 2 replenishment only) No   Paper Only
Other-SPANISH : Initial Lead Letter ExPECTT_Baseline (Baseline and Follow-up 2 replenishment only) No   Paper Only
Other-ENGLISH Incentive Thank You Letter ExPECTT 3 Baseline No   Paper Only
Other-SPANISH Incentive Thank You Letter ExPECTT 3 Baseline No   Paper Only
Other-ENGLISH Email Reminders ExPECTT3 Baseline Yes Yes Fillable Printable
Other-SPANISH Email Reminders ExPECTT3 Baseline Yes Yes Fillable Printable
Other-ENGLISH Eligibility Email ExPECTT 3 Baseline Yes Yes Fillable Printable
Other-SPANISH Eligibility Email ExPECTT 3 Baseline Yes Yes Fillable Printable
Other-ENGLISH Eligibility Letter ExPECTT 3 Baseline No   Paper Only
Other-SPANISH Eligibility Letter ExPECTT 3 Baseline No   Paper Only
Other-ENGLISH Questions and Answers about the Health and Media Study No   Paper Only
Other-SPANISH Questions and Answers about the Health and Media Study No   Paper Only
Other-ENGLISH Invitation Emails ExPECTT 3 Baseline Yes Yes Printable Only
Other-SPANISH Invitation Emails ExPECTT 3 Baseline Yes No Printable Only
Other-Text Message Reminder Yes No Printable Only
Other-ENGLISH Parent Guardian Online Screener Yes Yes Fillable Printable
Other-SPANISH Parent Guardian Screener Yes Yes Fillable Printable
Other-ENGLISH Parent Guardian Permission Yes Yes Fillable Printable
Other-SPANISH Parent Guardian Permission Yes Yes Fillable Printable
Other-ENGLISH Youth Assent 11 to 13 ExPECTT 3 Yes Yes Fillable Printable
Other-SPANISH Youth Assent 11 to 13 ExPECTT 3 Yes Yes Fillable Printable
Other-ENGLISH Youth Assent 14+ ExPECTT 3 Yes Yes Fillable Printable
Other-SPANISH Youth Assent 14+ ExPECTT 3 Yes Yes Fillable Printable
Other-ENGLISH Young Adult Consent ExPECTT 3 Yes Yes Fillable Printable
Other-SPANISH Young Adult Consent ExPECTT 3 Yes Yes Fillable Printable
Other-ENGLISH Youth Survey ExPECTT3 Yes Yes Fillable Printable
Other-SPANISH Youth Survey ExPECTT 3 Yes Yes Fillable Printable
Other-ENGLISH Panel Maintenance ExPECTT 3 Yes Yes Fillable Printable
Other-SPANISH Panel Maintenance ExPECTT 3 Yes Yes Fillable Printable
Other-ENGLISH Reminder Letters ExPECTT 3 Yes Yes Fillable Printable
Other-SPANISH Reminder Letters ExPECTT 3 Yes Yes Fillable Printable

Health Consumer Health and Safety

 

609,031 0
   
Individuals or Households
 
   99 %

  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 609,031 0 0 134,031 0 475,000
Annual IC Time Burden (Hours) 59,799 0 0 -11,451 0 71,250
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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