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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Health Communication Message Testing on Tuberculosis
Agency IC Tracking Number:
0920-0840-19YE
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
Form and Instruction
none
Recruitment Screener
Att 1b_RecruitmentScreener-CLEAN.docx
Yes
Yes
Fillable Fileable
Other-Moderator's Guide
Att 1a_Moderator'sGuide.docx
Yes
No
Paper 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:
6,885
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
6,885
0
6,885
0
0
0
Annual IC Time Burden (Hours)
1,080
0
1,080
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Supporting Statement B
SSB_DTBE-CLEAN.docx
02/21/2019
IRB Letter
Att 2a_Email-NoIRBNeeded.pdf
02/21/2019
Topics and messages for testing
Att 3_ThemesandMessages.docx
02/21/2019
TB Powerpoint
Att 4_EducationalPowerPoint.pdf
02/21/2019
Supporting Statement A
SSA_DTBE-2.28.19-Clean.docx
02/28/2019
PT2 Wrk Att1b_Screener
PT2 Wrk Att1b_Screener.pdf
02/28/2019
Pt2 Wrk Att1a_Moderator
PT2 Wrk Att 1a_Moderator.pdf
02/28/2019
Research Determination
Att 2b_Project-Determination-and-Approval-Form.pdf
02/28/2019
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.