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Cognitive Interviews for Risk and Benefit Perception Scale Development Study
Request for Generic Clearance of FDA, Testing Communications On Drugs
OMB: 0910-0695
IC ID: 210814
OMB.report
HHS/FDA
OMB 0910-0695
ICR 201106-0910-004
IC 210814
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0695 can be found here:
2024-03-07 - Extension without change of a currently approved collection
2022-06-30 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Appendix C -- Cognitivie Interview Guide and Questionnaire.doc
Other-Guide & Questionnaire
Appendix A -- Screener.doc
Other-other
Appendix B -- Consent Form.doc
Appendix B -- Consent Form
IC Document
OMB Justification for generic clearance of DTC TV AD study 3-14-14.doc
OMB Justification for generic clearance of DTC TV AD study 3-14-14
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Cognitive Interviews for Risk and Benefit Perception Scale Development Study
Agency IC Tracking Number:
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-Guide & Questionnaire
Appendix C -- Cognitivie Interview Guide and Questionnaire.doc
Yes
Yes
Fillable Fileable Signable
Other-other
Appendix A -- Screener.doc
Yes
Yes
Fillable Fileable Signable
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:
603
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
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
603
0
0
0
0
0
Annual IC Time Burden (Hours)
44
0
0
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Appendix B -- Consent Form
Appendix B -- Consent Form.doc
03/14/2014
OMB Justification for generic clearance of DTC TV AD study 3-14-14
OMB Justification for generic clearance of DTC TV AD study 3-14-14.doc
03/18/2014
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.