Communities

The Jackson Heart Study: Annual Follow-up with Third Party Respondents (NHLBI)

OMB: 0925-0491

IC ID: 205559

Information Collection (IC) Details

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Communities
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Pre-Post Testing Forms CHAN Attachment 1 -Pre-Post Testing CHAN.docx No No Paper Only
Form and Instruction 2 My Habits Pre-Post test Attachment 2-My Habits Pre-Post Test.docx No No Paper Only
Form and Instruction 3 CHA Diary Attachment 3 - CHA Diary.doc No No Paper Only
Form and Instruction 4 Train the Trainer Pre-Post Test Attachment 4 - Train the Trainer Pre-Post Test.docx No No Printable Only
Form and Instruction 5 Checklist Attachment 5-Checklists.docx No No Paper Only

Health Public Health Monitoring

 

78 0
   
Individuals or Households
 
   0 %

  Requested 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 780 0 780 0 0 0
Annual IC Time Burden (Hours) 1,170 0 1,170 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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