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Participant Telephone Interviews
The Hispanic Community Health Study/ Study of Latinos (HCHS/SOL)(NHLBI)
OMB: 0925-0584
IC ID: 182192
OMB.report
HHS/NIH
OMB 0925-0584
ICR 201110-0925-002
IC 182192
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0584 can be found here:
2014-07-17 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 1
Participant Telephone Interviews
Form and Instruction
1 Recall
Diet and Supplement Phone Script recall.doc
Form and Instruction
3 Informant
Informant Phone Script_Follow-up.doc
Form and Instruction
2 survey
Annual Followup_Y1_11-03-08annotated.doc
Form and Instruction
5 survey
Annual Followup_Y2_11-03-08annotated.doc
Form and Instruction
6 survey
Annual Followup_Y3_11-03-08annotated.doc
Form and Instruction
4 survey
Informant interview_10-20-08annotated.doc
Form and Instruction
7 survey
Exit Interview_10-24-08.doc
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Participant Telephone Interviews
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Removed
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
1
Recall
Diet and Supplement Phone Script recall.doc
Yes
Yes
Paper Only
Form and Instruction
3
Informant
Informant Phone Script_Follow-up.doc
Yes
Yes
Paper Only
Form and Instruction
2
survey
Annual Followup_Y1_11-03-08annotated.doc
Yes
Yes
Paper Only
Form and Instruction
5
survey
Annual Followup_Y2_11-03-08annotated.doc
Yes
Yes
Paper Only
Form and Instruction
6
survey
Annual Followup_Y3_11-03-08annotated.doc
Yes
Yes
Paper Only
Form and Instruction
4
survey
Informant interview_10-20-08annotated.doc
Yes
Yes
Paper Only
Form and Instruction
7
survey
Exit Interview_10-24-08.doc
Yes
Yes
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
5,333
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
0
0
-5,333
0
0
5,333
Annual IC Time Burden (Hours)
0
0
-3,573
0
0
3,573
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.