#10 Sub-study "Health Information National Trends Survey 4 (HINTS 4) Pilot Test "

Questionnaire Cognitive Interviewing and Pretesting (NCI)

OMB: 0925-0589

IC ID: 196228

Information Collection (IC) Details

View Information Collection (IC)

#10 Sub-study "Health Information National Trends Survey 4 (HINTS 4) Pilot Test "
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Pilot Test Questionnaire and Debriefing Questionnaire #10 HINTS Pilot_Attach B_E.docx Yes No Fillable Printable

Health Public Health Monitoring

SORN #09-25-0156, "Records of Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public Health Service, HHS/PHS/NIH/OD"  67 FR 60743

320 0
   
Individuals or Households
 
   0 %

  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 320 0 0 0 0 0
Annual IC Time Burden (Hours) 153 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
#10 Justif Memo HINTS Pilot & Attach A_C_D_F #10 Justif Memo HINTS Pilot & Attach A_C_D_F.doc 02/02/2011
#10_HINTS Pilot Gen IC form #10_HINTS Pilot Gen IC form.doc 02/02/2011
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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