Tailoring Gynecologic Cancer Education for Health Care Providers

Focus Group Testing to Effectively Plan and Tailor Cancer Prevention and Control Communication Campaigns--New

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0800 can be found here:

Documents and Forms

Document Name Document Type
Tailoring Gynecologic Cancer Education for Health Care Providers Form
Grp A Focus Group Guide App A Focus Group Guide Grp A 3 28 14 final.docx Form
Grp B Focus Group Guide App B Focus Group Guide HCP Grp B 3 28 14 final.docx Form
Recruitment Form App C recruitment form hcp 3 28 2014.doc Form
SS A_3 28 2014.docx SSA IC Document
SS B_3 28 2014.docx SSB IC Document
NCCDPHP 684 Form No IRB required.pdf IRB Documentation IC Document
App D Consent Form 3 28 14 final.doc Consent IC Document

Information Collection (IC) Details

IC Title:	Tailoring Gynecologic Cancer Education for Health Care Providers	Agency IC Tracking Number:	14SC

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	none	Grp A Focus Group Guide	App A Focus Group Guide Grp A 3 28 14 final.docx	Yes	No	Printable Only
Form	none	Grp B Focus Group Guide	App B Focus Group Guide HCP Grp B 3 28 14 final.docx	Yes	No	Printable Only
Form	none	Recruitment Form	App C recruitment form hcp 3 28 2014.doc	Yes	No	Printable Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 130	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	130	130
Annual IC Time Burden (Hours)	43	43
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SSA	SS A_3 28 2014.docx	04/24/2014
SSB	SS B_3 28 2014.docx	04/24/2014
IRB Documentation	NCCDPHP 684 Form No IRB required.pdf	04/24/2014
Consent	App D Consent Form 3 28 14 final.doc	04/24/2014

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