Individual Consumers: ETS health lesson learning questionnaires

National Hypertension Control Initiative

Documents and Forms

Document Name Document Type
Form 1 Individual Consumers: ETS health lesson learning questionnaires Form and Instruction
1 ETS Control Your Blood Pressure Appendix D1_ETS Control Your Blood Pressure.pdf Form and Instruction
1 ETS Control Your Blood Pressure Appendix D1_ETS Control Your Blood Pressure.pdf Form and Instruction
2 Salt and Cardiovascular Risk Appendix D2_ETS Salt and Cardiovascular Risk.pdf Form and Instruction
2 Salt and Cardiovascular Risk Appendix D2_ETS Salt and Cardiovascular Risk.pdf Form and Instruction
3 ET Get Active Appendix D3_ETS Get Active.pdf Form and Instruction
3 ET Get Active Appendix D3_ETS Get Active.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Individual Consumers: ETS health lesson learning questionnaires	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation: 5 CFR CFR 1320.8(d) (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	ETS Control Your Blood Pressure	Appendix D1_ETS Control Your Blood Pressure.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	2	Salt and Cardiovascular Risk	Appendix D2_ETS Salt and Cardiovascular Risk.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	3	ET Get Active	Appendix D3_ETS Get Active.pdf	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title: Individual Consumers: ETS health lesson learning questionnaires	FR Citation: 86 FR 70510

Number of Respondents: 3,120	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	3,120	3,120
Annual IC Time Burden (Hours)	1,872	1,872
Annual IC Cost Burden (Dollars)	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.