Revised Bundled Sub-study #2 and #3_Usability Testing for DCEG Newsletter Linkage and SEER Consolidated Cancer Statistics Tool

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0642 can be found here:

Documents and Forms

Document Name Document Type
Form 2.1 and 2.5 Revised Bundled Sub-study #2 and #3_Usability Testing for DCEG Newsletter Linkage and SEER Consolidated Cancer Statistics Tool Form and Instruction
2.1 and 2.5 DCEG Facilitator's Guide and System Usability Scale #2_DCEG_Attach 1 & 5_Facilitator Guide and SUS.doc Form and Instruction
3A and 3B SEER Screener for HC Prof and Public #3_SEER_Attach A&B_Screener for Health Prof and Public.doc Form and Instruction
3C SEER Moderator Guide for Public #3_SEER_Attach C_Guide Public.doc Form and Instruction
3E SEER Moderator Guide for Researcher #3_SEER_Attach E_Guide Researcher.docx Form and Instruction
3D SEER Moderator Guide for HC Professionals #3_SEER_Attach D_Guide Health Professional.docx Form and Instruction
3F SEER Moderator Guide for Media #3_SEER_Attach F_Guide Media.docx Form and Instruction
Memo to OMB_Key To Bundle #2 & 3.doc Memo to OMB Key to Bundle #2 & #3 IC Document
#2_DCEG Fast Track Request & Attach 2,3,4.doc #2 DCEG Fast Track Request and Attach 2, 3, & 4 IC Document
#3_SEER Fast-Track Request & Attachments GthruL.doc #3 SEER Fast Track Request and Attach G-L IC Document

Information Collection (IC) Details

IC Title:	Revised Bundled Sub-study #2 and #3_Usability Testing for DCEG Newsletter Linkage and SEER Consolidated Cancer Statistics Tool	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	2.1 and 2.5	DCEG Facilitator's Guide and System Usability Scale	#2_DCEG_Attach 1 & 5_Facilitator Guide and SUS.doc	Yes	No	Printable Only
Form and Instruction	3A and 3B	SEER Screener for HC Prof and Public	#3_SEER_Attach A&B_Screener for Health Prof and Public.doc	Yes	No	Printable Only
Form and Instruction	3C	SEER Moderator Guide for Public	#3_SEER_Attach C_Guide Public.doc	Yes	No	Printable Only
Form and Instruction	3E	SEER Moderator Guide for Researcher	#3_SEER_Attach E_Guide Researcher.docx	Yes	No	Printable Only
Form and Instruction	3D	SEER Moderator Guide for HC Professionals	#3_SEER_Attach D_Guide Health Professional.docx	Yes	No	Printable Only
Form and Instruction	3F	SEER Moderator Guide for Media	#3_SEER_Attach F_Guide Media.docx	Yes	No	Printable Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title: 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"	FR Citation: 67 FR 60743

Number of Respondents: 42	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 30 %

	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	42	0	0	0	0	0
Annual IC Time Burden (Hours)	43	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Memo to OMB Key to Bundle #2 & #3	Memo to OMB_Key To Bundle #2 & 3.doc	01/06/2012
#2 DCEG Fast Track Request and Attach 2, 3, & 4	#2_DCEG Fast Track Request & Attach 2,3,4.doc	01/06/2012
#3 SEER Fast Track Request and Attach G-L	#3_SEER Fast-Track Request & Attachments GthruL.doc	01/06/2012

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