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Sub-study #3_Health Information National Trends Survey 4 (HINTS 4) Cognitive Testing of Cycle 2 Instrument

IC 200806 under ICR 201103-0925-004 · OMB 0925-0589.

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

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Sub-study #3_Health Information National Trends Survey 4 (HINTS 4) Cognitive Testing of Cycle 2 Instrument
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 2 HINTS Cycle 2 Cognitive Interview Protocol #3_AttachB_Cycle 2 Cog Interview Protocol 1-13-2012.doc Yes No Printable Only
Form and Instruction 1 HINTS Cycle 2 Questionnaire #3_AttachA_HINTS_Cycle 2 Qx_1-12-2012.doc Yes No Printable Only
Form and Instruction 3 HINTS Cycle 2 Screener #3_AttachE_HINTS_Cycle 2_Screener.docx No Yes Printable Only

Health Consumer Health and Safety

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

93 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 93 0 0 0 0 0
Annual IC Time Burden (Hours) 65 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Justification Memo & Attachments C, D, F, and G HINTS Cycle 2 #3_Justif_MemoAttachments_C_D_F_G_HINTS_Cycle2_01-12-12.DOC 01/12/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.