Program Directors

Use of Evidence Based Practices for Comprehensive Cancer Control

Documents and Forms

Document Name Document Type
Program Directors Form and Instruction
Phone Interview Attachment C2. Program Directors telephone interview script.docx Form and Instruction
Scheduling Script Attachment C4. Program Directors survey scheduling script.docx Form and Instruction
Web Survey Instrument Attachment C1. Program Director Web Survey_rev 1 18 2012.docx Form and Instruction
Attachment C3. Program Directors Advance Letter.docx Att C3 - Advance Letter IC Document
Attachment C5. Program Director Follow Up Emails.docx Att C5 - Follow-up Email IC Document

Information Collection (IC) Details

IC Title:	Program Directors	Agency IC Tracking Number:

Is this a Common Form? No		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	none	Phone Interview	Attachment C2. Program Directors telephone interview script.docx	No	No	Fillable Fileable
Form and Instruction	none	Scheduling Script	Attachment C4. Program Directors survey scheduling script.docx	No	No	Fillable Fileable
Form and Instruction	none	Web Survey Instrument	Attachment C1. Program Director Web Survey_rev 1 18 2012.docx	Yes	No	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 66	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	66	66
Annual IC Time Burden (Hours)	72	72
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Att C3 - Advance Letter	Attachment C3. Program Directors Advance Letter.docx	10/31/2011
Att C5 - Follow-up Email	Attachment C5. Program Director Follow Up Emails.docx	10/31/2011

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