Usability Study of Medscape's Technology-based Panel

Formative Research and Tool Development

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0840 can be found here:

Documents and Forms

Document Name Document Type
Usability Study of Medscape's Technology-based Panel Form
Screener Attach2 PIC_HSSC Medscape Screener 3-4-11.docx Form
Questionnaire Attach1 PIC_HSSC Medscape Questionnaire 2-25-11.docx Form
Attach3_Informed Consent 3-25-11.docx Consent IC Document
Attach4_Medscape email notification 3-4-11.doc Email notification IC Document
Medscape Usability IRB Approval Notice.pdf IRB Approval IC Document
SS Part A_PIC_HSSC Medscape 3-28-11FINAL.docx Supporting Statement IC Document
WebMD RTI-CDC Screenshots.docx Screenshots IC Document

Information Collection (IC) Details

IC Title:	Usability Study of Medscape's Technology-based Panel	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	none	Screener	Attach2 PIC_HSSC Medscape Screener 3-4-11.docx		Yes	Yes	Fillable Fileable
Form	none	Questionnaire	Attach1 PIC_HSSC Medscape Questionnaire 2-25-11.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 16,800	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	16,800	0	0	0	0	0
Annual IC Time Burden (Hours)	934	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Consent	Attach3_Informed Consent 3-25-11.docx	08/17/2011
Email notification	Attach4_Medscape email notification 3-4-11.doc	08/17/2011
IRB Approval	Medscape Usability IRB Approval Notice.pdf	08/17/2011
Supporting Statement	SS Part A_PIC_HSSC Medscape 3-28-11FINAL.docx	08/17/2011
Screenshots	WebMD RTI-CDC Screenshots.docx	08/17/2011

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