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Semi-structured interviews with Adolescents(13 to 20 years of age)
Understanding Patient's Knowledge and Use of Acetaminophen
OMB: 0935-0154
IC ID: 189143
OMB.report
HHS/AHRQ
OMB 0935-0154
ICR 200905-0935-002
IC 189143
( )
Documents and Forms
Document Name
Document Type
Form Form #5
Semi-structured interviews with Adolescents(13 to 20 years of age)
Form
Form #5 Semi-structured interviews with Adolescents
Attachment E--Semi-structured interview with Adolscents.pdf
Form
Attachment E1 -- Adolescent Recruit Letter.doc
Attachment E1 -- Adolescent Recruit Letter
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Semi-structured interviews with Adolescents(13 to 20 years of age)
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
Form
Form #5
Semi-structured interviews with Adolescents
Attachment E--Semi-structured interview with Adolscents.pdf
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:
20
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
20
0
20
0
0
0
Annual IC Time Burden (Hours)
10
0
10
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Attachment E1 -- Adolescent Recruit Letter
Attachment E1 -- Adolescent Recruit Letter.doc
05/11/2009
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.