Information Collection

Focus Groups for Message and Materials Pretesting

IC 187086 under ICR 200712-0925-002 · OMB 0925-0585.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0585 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Focus Groups for Message and Materials Pretesting	Form and Instruction
1 survey Appendix 1 Focus Group Moderators Guide 08-1021.doc	Form and Instruction
2 survey Appendix_4_screener_FG_08-1023.doc	Form and Instruction
FG Draft Mini Supporting Statement 08-1023 (2).doc FG Draft Mini Supporting Statement 08-1023 (2)	IC Document
Appendix 3 AED Guidelines for Data Security.doc Appendix 3 AED Guidelines for Data Security	IC Document
Appendix 5 Notification.doc Appendix 5 Notification	IC Document
Appendix 7 IRB Exemption Review.doc Appendix 7 IRB Exemption Review	IC Document
FG OMB Cover Ltr 08-1023.doc FG OMB Cover Ltr 08-1023	IC Document
Appendix 6 Informed Consent.doc Appendix 6 Informed Consent	IC Document
FG GenericClearanceForm1 08-1023 KEK.DOC FG GenericClearanceForm1 08-1023 KEK	IC Document

IC Title:

Focus Groups for Message and Materials Pretesting

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	survey	Appendix 1 Focus Group Moderators Guide 08-1021.doc		Yes	Yes	Paper Only
Form and Instruction	2	survey	Appendix_4_screener_FG_08-1023.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 216

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	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	216	0	0	0	0	0
Annual IC Time Burden (Hours)	432	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
FG Draft Mini Supporting Statement 08-1023 (2)	FG Draft Mini Supporting Statement 08-1023 (2).doc	10/27/2008
Appendix 3 AED Guidelines for Data Security	Appendix 3 AED Guidelines for Data Security.doc	10/27/2008
Appendix 5 Notification	Appendix 5 Notification.doc	10/27/2008
Appendix 7 IRB Exemption Review	Appendix 7 IRB Exemption Review.doc	10/27/2008
FG OMB Cover Ltr 08-1023	FG OMB Cover Ltr 08-1023.doc	10/27/2008
Appendix 6 Informed Consent	Appendix 6 Informed Consent.doc	10/27/2008
FG GenericClearanceForm1 08-1023 KEK	FG GenericClearanceForm1 08-1023 KEK.DOC	10/27/2008

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.