Information Collection Request

Development of a Health Information Rating System (HIRS)

ICR 201301-0935-002 · OMB 0935-0207 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form Form #4 Health Education Materials & Questionnaire - Colonoscopy Form and Instruction Modified Available
Form Form #3 Health Education Materials & Questionnaire - Inhaler Form and Instruction Modified Available
Form Form #2 S-TOFHLA Questionnaire Form and Instruction Modified Available
Form Form #1 Demographic Questionnaire Form and Instruction Modified Available
Supporting Statement B -- Development of a Health Information Rating System 1-17-2013.doc Supporting Statement B Uploaded 2013-01-17 Available
Attachment I - Consent Form.doc Supplementary Document Uploaded 2013-01-17 Available
Attachment G - Federal Register Notice.pdf Supplementary Document Uploaded 2013-01-17 Available
Attachment B - Health Information Rating System (HIRS).docx Supplementary Document Uploaded 2013-01-17 Available
Attachment A - Description of All Project Tasks.docx Supplementary Document Uploaded 2013-01-17 Available
Attachment H -- Public Comment & AHRQs Response.docx Supplementary Document Uploaded 2013-01-17 Available
Supporting Statement A -- Development of a Health Information Rating System 9-18-2012.doc Supporting Statement A Uploaded 2013-01-17 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
204410 Health Education Materials & Questionnaire - Colonoscopy Form and Instruction Modified
204409 Health Education Materials & Questionnaire - Inhaler Form and Instruction Modified
204408 S-TOFHLA Questionnaire Form and Instruction Modified
204407 Demographic Questionnaire Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
08/31/2013 6 Months From Approved
192 0 0
58 0 0
0 0 0





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 192 0 0 192 0 0
Annual Time Burden (Hours) 58 0 0 58 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No