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Screening Process for Children Recruited for Child-Only Focus Groups
Formative Evaluation of Adults' and Children's Views Related to Promotion of Healthy Food Choices
OMB: 0920-0795
IC ID: 184644
OMB.report
HHS/CDC
OMB 0920-0795
ICR 200804-0920-005
IC 184644
( )
Documents and Forms
Document Name
Document Type
Appendix D2 Screener for Child-Only Focus Groups Phase1-2.doc
Other-Recruitment Screening Instrume
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Screening Process for Children Recruited for Child-Only Focus Groups
Agency IC Tracking Number:
Is this a Common Form?
No
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-Recruitment Screening Instrument for Child-Only Focus Groups
Appendix D2 Screener for Child-Only Focus Groups Phase1-2.doc
No
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
384
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
384
0
384
0
0
0
Annual IC Time Burden (Hours)
19
0
19
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.