Assessing Survivors' Cognitive, Affective and Information-Seeking Responses to Different Formats to Communicate Cancer Survival Statistics - Sub-Study #1

Questionnaire Cognitive Interviewing and Pretesting (NCI)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0589 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Assessing Survivors' Cognitive, Affective and Information-Seeking Responses to Different Formats to Communicate Cancer Survival Statistics - Sub-Study #1 Form
1 Screener & Survey Sub-Study #1 Screener & Survey_Sub-Study #1_WATERS_12 11 08.doc Form
Willis' Memo Sub-Study #1_WATERS_12 11 08.doc Memo Sub-Study #1 IC Document

Information Collection (IC) Details

IC Title:	Assessing Survivors' Cognitive, Affective and Information-Seeking Responses to Different Formats to Communicate Cancer Survival Statistics - Sub-Study #1	Agency IC Tracking Number:

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	1	Screener & Survey Sub-Study #1	Screener & Survey_Sub-Study #1_WATERS_12 11 08.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 300	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	300	0	0	0	0	0
Annual IC Time Burden (Hours)	100	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Memo Sub-Study #1	Willis' Memo Sub-Study #1_WATERS_12 11 08.doc	12/11/2008

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