Screener for Primary Pre and Post Campaign Survey

Evaluation of the Spanish-Language Campaign "Good Morning Arthritis, Today You Will Not Defeat Us"

OMB: 0920-0766

IC ID: 183072

Documents and Forms
Document Name
Document Type
Other-Telephone Script
Information Collection (IC) Details

View Information Collection (IC)

Screener for Primary Pre and Post Campaign Survey
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Telephone Script Appendix D1 Baseline Screener.doc Yes No Fillable Printable

Health Illness Prevention

 

60,000 0
   
Individuals or Households
 
   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 60,000 0 60,000 0 0 0
Annual IC Time Burden (Hours) 2,000 0 2,000 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.

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