Testing Solutions for Sampling Challenges for MMP

Formative Research and Tool Development

OMB: 0920-0840

IC ID: 207572

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Information Collection (IC) Details

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Testing Solutions for Sampling Challenges for MMP
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none 2a - Interview questionnaire - English MMP GenIC_Testing Sampling_Att 2a_MMP Formative Research Interview_English.docx Yes Yes Fillable Fileable
Form none 2b - interview questionnaire - Spanish MMP GenIC_Testing Sampling_Att 2b_MMP Formative Research Interview_Spanish.docx Yes Yes Fillable Fileable

Health Immunization Management

 

2,850 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 2,850 0 0 0 0 0
Annual IC Time Burden (Hours) 983 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement A MMP GenIC_Testing Sampling_Supporting Statement A.docx 06/24/2013
Supporting Statement B MMP GenIC_Testing Sampling_Supporting Statement B.docx 06/24/2013
1 - Authorizing Legislation MMP GenIC_Testing Sampling_Att 1_Research Sect 301 PHSA.pdf 06/24/2013
3a - MMP Medical Record Abstraction form MMP GenIC_Testing Sampling_Att 3a_MMP_2013_MRA_MHF_v7 1 0.doc 06/24/2013
3b - MMP Surveillance Summary Form MMP GenIC_Testing Sampling_Att 3b_MMP_2013_MRA_SPSF_v7 1 0.doc 06/24/2013
3c - MMP Surveillance Visit Form MMP GenIC_Testing Sampling_Att 3c_MMP_2013_MRA_SPVF_v7 1 0.doc 06/24/2013
3d - MMP Surveillance Inpatient Form MMP GenIC_Testing Sampling_Att 3d_MMP_2013_MRA_SPIF_v7 1 0.doc 06/24/2013
4a - MMP variables MMP GenIC_Testing Sampling_Att 4a_MMP_MDS Person level variables_eHARS.docx 06/24/2013
4b - MMP variables MMP GenIC_Testing Sampling_Att 4b_MMP_MDS Person level variables based on eHARS.docx 06/24/2013
4c - MMP variables MMP GenIC_Testing Sampling_Att 4c_MMP_MDS Lab level variables.docx 06/24/2013
5a - Process documentation form MMP GenIC_Testing Sampling_Att 5a MMP_Research Process Doc Form.docx 06/24/2013
5b - Contact attempt tracking MMP GenIC_Testing Sampling_Att 5b MMP_Contact Attempt Tracking Database.docx 06/24/2013
6a - Assurance of Confidentiality MMP GenIC_Testing Sampling_Att 6a_MMP_Assurance of Conf.doc 06/24/2013
6b - Authorization to Operate MMP GenIC_Testing Sampling_Att 6b_MMP_DCC_Auth to operate.pdf 06/24/2013
7 - Recruitment script MMP GenIC_Testing Sampling_Att 7_MMP_Recruitment Guidance_First Contact.docx 06/24/2013
8 - Data release agreement MMP GenIC_Testing Sampling_Att 8_MMP_Data Release Agreement.doc 06/24/2013
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