Health and Media Survey

Community Transformation Grants: Evaluation of Nutrition, Physical Activity, and Obesity-related Television Media Campaigns

OMB: 0920-0967

IC ID: 204661

Information Collection (IC) Details

View Information Collection (IC)

Health and Media Survey
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction None Attachment 6a Health and Media Survey Attachment 6a_Health and Media Survey_022613.docx Yes Yes Fillable Fileable
Form and Instruction None Attachment 6b Health and Media Survey Attachment 6b (rev) Health and Media Survey Screenshots.pdf Yes Yes Fillable Fileable

Health Public Health Monitoring

 

15,399 0
   
Individuals or Households
 
   100 %

  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 15,399 0 15,399 0 0 0
Annual IC Time Burden (Hours) 7,700 0 7,700 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Attachment 8_Email Notification and Reminders Attachment 8_Email Notification and Reminders.docx 10/29/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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