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Outcome Screener via Social Media
Food and Drug Administration's Research and Evaluation Survey for the Public Education Campaign on Tobacco among LGBT (RESPECT)
OMB: 0910-0808
IC ID: 218384
OMB.report
HHS/FDA
OMB 0910-0808
ICR 201606-0910-006
IC 218384
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0808 can be found here:
2018-12-12 - Revision of a currently approved collection
2018-07-26 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Attachment5_ScreenerInformedConsent.docx
Other-Screener Informed Consent
Attachment3_Screener.docx
Other-Screener
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Outcome Screener via Social Media
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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-Screener Informed Consent
Attachment5_ScreenerInformedConsent.docx
Yes
Yes
Fillable Fileable
Other-Screener
Attachment3_Screener.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
2,189
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
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
2,189
0
0
0
0
2,189
Annual IC Time Burden (Hours)
181
0
0
0
0
181
Annual IC Cost Burden (Dollars)
0
0
0
0
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.