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Conduct Cognitive Testing of Test Survey Questions
Comprehensive Communication Campaign for HITECH ACT
OMB: 0990-0376
IC ID: 200298
OMB.report
HHS/HHSDM
OMB 0990-0376
ICR 201106-0990-003
IC 200298
( )
Documents and Forms
Document Name
Document Type
0990-0376_Attachment 1 Consumer Privacy Security Cognitive Recruitment Screener.docx
Other-testing
0990-0376_Attachment 2 Consumer Privacy Security Cognitive Interview Protocol.docx
Other-testing
0990-0376_Attachement 3 Consumer Privacy Security Survey Questions.docx
Other-testing
0990-0376_Attachment 4 Consumer Privacy Security Spanish Cognitive Recruitment Screener.doc
Other-test
0990-0376_Attachment 6 Consumer Privacy Security Spanish Survey Questions Main.docx
Other-test
0990-0376_Attachment 5 Consumer Privacy Security Spanish Cognitive Interview Protocol.docx
0990-0376_Attachment 5 Consumer Privacy Security Spanish Cognitive Interview Protocol
IC Document
0990-0376_Mini Supporting Statement Cognitive Testing Consumer Privacy Security.docx
0990-0376_Mini Supporting Statement Cognitive Testing Consumer Privacy Security
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Conduct Cognitive Testing of Test Survey Questions
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-testing
0990-0376_Attachment 1 Consumer Privacy Security Cognitive Recruitment Screener.docx
Yes
Yes
Fillable Printable
Other-testing
0990-0376_Attachment 2 Consumer Privacy Security Cognitive Interview Protocol.docx
Yes
Yes
Printable Only
Other-testing
0990-0376_Attachement 3 Consumer Privacy Security Survey Questions.docx
Yes
Yes
Printable Only
Other-test
0990-0376_Attachment 4 Consumer Privacy Security Spanish Cognitive Recruitment Screener.doc
Yes
Yes
Printable Only
Other-test
0990-0376_Attachment 6 Consumer Privacy Security Spanish Survey Questions Main.docx
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
25
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
25
0
0
0
0
0
Annual IC Time Burden (Hours)
38
0
0
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
0990-0376_Attachment 5 Consumer Privacy Security Spanish Cognitive Interview Protocol
0990-0376_Attachment 5 Consumer Privacy Security Spanish Cognitive Interview Protocol.docx
11/30/2011
0990-0376_Mini Supporting Statement Cognitive Testing Consumer Privacy Security
0990-0376_Mini Supporting Statement Cognitive Testing Consumer Privacy Security.docx
11/30/2011
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.