Information Collection

Consumer perceptions as a foundation for CTP positioning initiative

IC 201564 under ICR 201103-0910-003 · OMB 0910-0497.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0497 can be found here:

Documents and Forms

Document Name Document Type
CTP Positioning DOC 03_Adolescent Screener.doc Other-Adolescent Screener
CTP Positioning DOC 04_Adult Screener.doc Other-Adult Screener
CTP Positioning DOC 05_Adolescent Assent Form.doc Other-Adolescent Assent Form
CTP Positioning DOC 06_Adult Informed Consent.doc Other-Adult Informed Consent
CTP Positioning DOC 01_Generic Clearance Memorandum.doc OMB Justification Memo IC Document
CTP Positioning DOC 02_Focus Group Composition.doc CTP Positioning DOC 02_Focus Group Composition IC Document
CTP Positioning DOC 07_Adolescent Moderators Guide.doc CTP Positioning DOC 07_Adolescent Moderators Guide IC Document
CTP Positioning DOC 08_Adult Moderators Guide.doc CTP Positioning DOC 08_Adult Moderators Guide IC Document
CTP Positioning DOC 09_CTP Description.doc CTP Positioning DOC 09_CTP Description IC Document
CTP Positioning DOC 10_Territory Stimuli.pptx CTP Positioning DOC 10_Territory Stimuli IC Document
CTP Positioning DOC 11_Interbrand Nondisclosure Agreement.pdf CTP Positioning DOC 11_Interbrand Nondisclosure Agreement IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Consumer perceptions as a foundation for CTP positioning initiative	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Adult Screener	CTP Positioning DOC 04_Adult Screener.doc	Yes	No	Paper Only
Other-Adolescent Assent Form	CTP Positioning DOC 05_Adolescent Assent Form.doc	Yes	No	Paper Only
Other-Adult Informed Consent	CTP Positioning DOC 06_Adult Informed Consent.doc	Yes	No	Paper Only
Other-Adolescent Screener	CTP Positioning DOC 03_Adolescent Screener.doc	Yes	No	Paper Only

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 64	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 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	64	0	0	0	0	0
Annual IC Time Burden (Hours)	128	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
OMB Justification Memo	CTP Positioning DOC 01_Generic Clearance Memorandum.doc	03/14/2012
CTP Positioning DOC 02_Focus Group Composition	CTP Positioning DOC 02_Focus Group Composition.doc	03/14/2012
CTP Positioning DOC 07_Adolescent Moderators Guide	CTP Positioning DOC 07_Adolescent Moderators Guide.doc	03/14/2012
CTP Positioning DOC 08_Adult Moderators Guide	CTP Positioning DOC 08_Adult Moderators Guide.doc	03/14/2012
CTP Positioning DOC 09_CTP Description	CTP Positioning DOC 09_CTP Description.doc	03/14/2012
CTP Positioning DOC 10_Territory Stimuli	CTP Positioning DOC 10_Territory Stimuli.pptx	03/14/2012
CTP Positioning DOC 11_Interbrand Nondisclosure Agreement	CTP Positioning DOC 11_Interbrand Nondisclosure Agreement.pdf	03/14/2012

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