Information Collection

Focus Group for Insider Knowledge:Get the Facts about Gynecologic Cancer

IC 189077 under ICR 200906-0920-015 · OMB 0920-0800.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0800 can be found here:

Documents and Forms

Document Name Document Type
Focus Group for Insider Knowledge:Get the Facts about Gynecologic Cancer Form
Recruitment screener C1-1 GYN Consumer Screener 4 17 09.doc Form
2 Final Consumer Screener C1-1_GYN_Consumer_Screener_05_12_09.doc Form
C1-2 GYN Consumer Mod Guide 4 17 09.doc Focus Group Guide IC Document
C1-3 Participant Consent Form 4 17 09.doc Consent form IC Document
C1-2_GYN_Mod_Guide_05_11_09.doc Final Focus Group Guide IC Document
Terms of Clearance.pdf Terms of Clearance IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Focus Group for Insider Knowledge:Get the Facts about Gynecologic Cancer	Agency IC Tracking Number:

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
Form	none	Recruitment screener	C1-1 GYN Consumer Screener 4 17 09.doc		No	No	Paper Only
Form	2	Final Consumer Screener	C1-1_GYN_Consumer_Screener_05_12_09.doc		No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 432	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	432	432
Annual IC Time Burden (Hours)	346	346
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Focus Group Guide	C1-2 GYN Consumer Mod Guide 4 17 09.doc	04/23/2009
Consent form	C1-3 Participant Consent Form 4 17 09.doc	04/23/2009
Final Focus Group Guide	C1-2_GYN_Mod_Guide_05_11_09.doc	05/26/2009
Terms of Clearance	Terms of Clearance.pdf	05/26/2009

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