Audience Research on Self-Management Education

CDC and ATSDR Health Message Testing System

OMB: 0920-0572

IC ID: 207102

Information Collection (IC) Details

View Information Collection (IC)

Audience Research on Self-Management Education
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction none Moderator's Guide Attachment 3 - Moderators Guide 052313.docx No No Printable Only
Form and Instruction none Screener Attachment 2 - Eligibility Screener 052313.docx Yes No Fillable Printable

Health Immunization Management

 

120 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 120 0 0 0 0 120
Annual IC Time Burden (Hours) 200 0 0 0 0 200
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Consent Attachment 4- Informed Consent Form 052313.docx 05/29/2013
Materials Attachment 5 - Materials 052313.docx 05/29/2013
Expedited Review Form DPH_HMTS Expedited Review Form 052313.docx 05/29/2013
Supporting Information Attachment 1 - Research Plan - Burden Table 052313.docx 05/29/2013
List of Attachments List of Attachments 052313.docx 05/29/2013
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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