Interview Guide for Grantee Private Sector Partners

Impact Evaluation of CDC's Colorectal Cancer Control Program

Documents and Forms

Document Name Document Type
Interview Guide for Grantee Private Sector Partners Form
Interview Guide for Grantee Partners ATT 7C Grantee Partner Interview Guide 7.18.2013.docx Form
ATT 7D Informed Consent Form.docx Consent IC Document

Information Collection (IC) Details

IC Title:	Interview Guide for Grantee Private Sector Partners	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	Interview Guide for Grantee Partners	ATT 7C Grantee Partner Interview Guide 7.18.2013.docx		No	No	Printable Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title: Epidemiologic Studies and Surveillance of Disease Problems	FR Citation: 57 FR 62812

Number of Respondents: 4	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	4	4
Annual IC Time Burden (Hours)	4	4
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Consent	ATT 7D Informed Consent Form.docx	07/22/2013

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