Healthy School Environment

Generic Clearance to Conduct Formative Research

P - Agreement on Security of Comments_Adults_Revised

Healthy School Environment

OMB: 0584-0524

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Attachment P

OMB Control # 0584-0524

Expiration Date: 03/31/2013


OMB BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0584-0524. The time to complete this information collection is estimated as part of the 15 minutes for the screener, including the time for reviewing instructions and completing the information.



USDA Food Guidance System

Agreement on Security of Comments for Adults



I, __________________________(print name), agree to keep all information shown and discussed during the USDA focus group in which I am participating in the strictest confidence.


I agree not to discuss, publish, or otherwise divulge any information I am exposed to, in whole or in part, in any manner or form.




Signed:___________________________ Dated: ____________________



Your comments will be kept private and only used for research purposes, except as otherwise required by law. Your name will not be divulged in any reports of this focus group.



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleUSDA NON-DISCLOSURE
AuthorTech Services
File Modified0000-00-00
File Created2021-02-02

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