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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
(HFP) Environmental Contaminants (Toxic Elements) Focus Groups – Two Waves
Agency IC Tracking Number:
HFP
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-Appendix I - Parents Screener
Appendix I Parents Participant Screener-090126.docx
Yes
Yes
Fillable Fileable
Other-Appendix II - HCP & NE Screener
Appendix II HCP & NE Participant Screener-090126.docx
Yes
Yes
Fillable Fileable
Other-Appendix III - Parents Informed Consent
Appendix III Parents Focus Groups Informed Consent Form-090126.docx
Yes
Yes
Fillable Fileable
Other-Appendix IV HCP & NE Informed Consent
Appendix IV HCP & NE Focus Groups Informed Consent Form-090126.docx
Yes
Yes
Fillable Fileable
Other-Appendix V - Parents Moderator Guide
Appendix V Parents Moderator Guide-090126.docx
Yes
Yes
Fillable Printable
Other-Appendix VI - NE Moderator Guide
Appendix VI HCP NE Moderator Guide-090126.docx
Yes
Yes
Fillable Printable
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:
768
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
768
0
768
0
0
0
Annual IC Time Burden (Hours)
332
0
332
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Cover Memo for Environmental Contaminants (Toxic Elements) - Two Waves
OMB Memo Toxic Elements-090226.docx
09/02/2026
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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