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Scholastic Vaping Education Materials Survey (CTP)
Customer/Partner Satisfaction Service Surveys
OMB: 0910-0360
IC ID: 248333
OMB.report
HHS/FDA
OMB 0910-0360
ICR 202206-0910-014
IC 248333
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0360 can be found here:
2023-09-07 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Screener.docx
Other-Screener
Screener.docx
Other-Screener
Qualtrics Survey - Scholastic Vaping Materials Survey.pdf
Other-Survey Instrument
Qualtrics Survey - Scholastic Vaping Materials Survey.pdf
Other-Survey Instrument
Informed Consent - Scholastic Vaping Materials Survey.docx
Other-Informed Consent
Informed Consent - Scholastic Vaping Materials Survey.docx
Other-Informed Consent
0360 OMB Approval Memo - Scholastic Vaping Materials Survey 2021.docx
OMB Approval Memo
IC Document
0360 OMB Approval Memo - Scholastic Vaping Materials Survey 2021.docx
OMB Approval Memo
IC Document
IRB Letter.pdf
IRB Letter
IC Document
IRB Letter.pdf
IRB Letter
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Scholastic Vaping Education Materials Survey (CTP)
Agency IC Tracking Number:
CTP
IC Status:
Unchanged
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
Screener.docx
Yes
Yes
Fillable Fileable
Other-Survey Instrument
Qualtrics Survey - Scholastic Vaping Materials Survey.pdf
Yes
Yes
Fillable Fileable
Other-Informed Consent
Informed Consent - Scholastic Vaping Materials Survey.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:
3,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
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
3,000
0
0
0
0
3,000
Annual IC Time Burden (Hours)
766
0
0
0
0
766
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
OMB Approval Memo
0360 OMB Approval Memo - Scholastic Vaping Materials Survey 2021.docx
07/12/2021
IRB Letter
IRB Letter.pdf
07/12/2021
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.