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HCP Audience Feedback Team Screener
Federal COVID Response - Audience Feedback to Inform Ongoing Messaging and Strategies for "Combat COVID" (OD)
OMB: 0925-0769
IC ID: 247685
OMB.report
HHS/NIH
OMB 0925-0769
ICR 202105-0925-001
IC 247685
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0769 can be found here:
2021-11-23 - Extension without change of a currently approved collection
2021-11-10 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form 2
HCP Audience Feedback Team Screener
Form and Instruction
2 HCP Recruitment Screener
Attachment 2 - HCP Recruitment Screener 051921.docx
Form and Instruction
2 HCP Recruitment Screener
Attachment 2 - HCP Recruitment Screener update 061721.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
HCP Audience Feedback Team Screener
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 and Instruction
2
HCP Recruitment Screener
Attachment 2 - HCP Recruitment Screener update 061721.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
40
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
40
0
40
0
0
0
Annual IC Time Burden (Hours)
3
0
3
0
0
0
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.