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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Site Recruitment and Training
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
2
Attachment10 National_Awardee and Site Recruitment Materials_3-23-20
Attachment10 National_Awardee and Site Recruitment Materials_final 10_29_2019_psg.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
700
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
700
0
0
0
0
700
Annual IC Time Burden (Hours)
2,205
0
0
0
0
2,205
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Receptionist Recruitment Script_Phone_version
Receptionist Recruitment Script_Phone_version.docx
12/11/2020
Receptionist Recruitment Script_Chinese_psg
Receptionist Recruitment Script_English_TChinese_psg.docx
12/11/2020
Receptionist Recruitment Script_Spanish_psg
Receptionist Recruitment Script_Spanish_psg.docx
12/11/2020
Receptionist Recruitment Script_Viet_psg
Receptionist Recruitment Script_Viet_psg.docx
12/11/2020
Interviewer Recruitment Script final_Phone_version
Interviewer Recruitment Script final_Phone_version.docx
12/11/2020
Interviewer Recruitment Script final_TChinese_Phone
Interviewer Recruitment Script final_TChinese_Phone.docx
12/11/2020
Phone Version Interviewer Recruitment Script final_Spanish_psg
Phone Version Interviewer Recruitment Script final_Spanish_psg.docx
12/11/2020
Interviewer Recruitment Script final VIET_psg
Interviewer Recruitment Script final VIET_psg.docx
12/11/2020
Attachment 13 Receptionist Recruitment Script at clinic Tagalog_psg
Attachment 13 Receptionist Recruitment Script at clinic Tagalog_psg.docx
12/11/2020
Attachment 13 Interviewer Recruitment Script_Tagalog_psg
Attachment 13 Interviewer Recruitment Script_Tagalog_psg.docx
12/11/2020
Flyer to Hand to Patients
Flyer to Hand to Patients.docx
12/11/2020
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.