Pre-test CATI Screener/CATI Recruitment

Use of Smartphones to Collect Information about Health Behaviors: Feasibility Study

Documents and Forms

Document Name Document Type
Pre-test CATI Screener/CATI Recruitment Form
Pre-test Screener Appendix C1. Screener - CATI Recruitment.docx Form
CATI Survey Appendix D. Initial CATI Survey.docx Form

Information Collection (IC) Details

IC Title:	Pre-test CATI Screener/CATI Recruitment	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	none	Pre-test Screener	Appendix C1. Screener - CATI Recruitment.docx		Yes	Yes	Fillable Fileable
Form	none	CATI Survey	Appendix D. Initial CATI Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

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: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	20	20
Annual IC Time Burden (Hours)	3	3
Annual IC Cost Burden (Dollars)	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.