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

View Information Collection (IC)

National Outreach Campaign WIC – In-depth Interviews among Healthcare Professionals.
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Attachment A-1 WIC HCP IDI Screener Attachment A-1 WIC HCP IDI Screener -20231024.docx Yes Yes Fillable Printable
Other-Attachment B-1 Confirmation Form Attachment B-1 Confirmation Form .docx Yes Yes Fillable Printable
Other-Attachment C-1 Consent Form Attachment C-1 Consent Form.docx Yes Yes Fillable Printable
Other-Attachment D-1 WIC HCP IDI Guide Attachment D-1 WIC HCP IDI Guide .docx Yes Yes Fillable Printable

Income Security Food and Nutrition Assistance

 

500 0
   
Individuals or Households
 
   100 %

  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 500 0 0 0 0 500
Annual IC Time Burden (Hours) 103 0 0 0 0 103
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
National Outreach Campaign WIC – In-depth Interviews among Healthcare Professionals - Memo Fast Track Clearance WIC Outreach Campaign HCP IDIs 20231130-1.docx 12/01/2023
Attachment E2 - IRB Determination Notice Attachment E-1 Determination Notice for Non Human Subjects Research (1).pdf 12/01/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.