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Federal forms, ICRs, and supporting documents

Information Collection

Health Provider Formative Focus Group Testing for the Inside Knowledge: Get the Facts about Gynecologic Cancer Campaign

IC 197402 under ICR 200906-0920-015 · OMB 0920-0800.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Health Provider Formative Focus Group Testing for the Inside Knowledge: Get the Facts about Gynecologic Cancer Campaign
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction none Screener for Gynecologists IC 4_Att 1_Screener for Gynecologists 4 14 2011.doc No No Fillable Fileable
Form and Instruction none Screener for Primary Care Providers IC 4_Att 2_Screener for Primary Care Providers 4 14 2011.doc No No Fillable Fileable
Form and Instruction none Moderator Guide IC 4_Att 4_Moderators Guide 4.14.11.doc No No Paper Only

Health Consumer Health and Safety

 

720 0
   
Private Sector Businesses or other for-profits
 
   67 %

  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 720 0 0 0 0 0
Annual IC Time Burden (Hours) 384 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Consent IC 4_Att 3_Consent Form 4 14 2011.doc 04/14/2011
Supporting Statement IC 4_Justification 4 14 2011.doc 04/14/2011
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.