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Federal forms, ICRs, and supporting documents

Information Collection

The Population Assessment of Tobacco and Health (PATH) Study- Focus Groups to Support Development of E-Cigarette and Hookah Questionnaire Items

IC 210595 under ICR 201303-0925-001 · OMB 0925-0675.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form B.
Screener for E-cigarette and Hookah Focus focus group The Population Assessment of Tobacco and Health (PATH) Study- Focus Groups to Support Development of E-Cigarette and Hookah Questionnaire Items		 Form and Instruction
Form C.
E-Cigarette Focus Group Moderator Guide The Population Assessment of Tobacco and Health (PATH) Study- Focus Groups to Support Development of E-Cigarette and Hookah Questionnaire Items		 Form and Instruction
Form D,
Hookah Moderator's Guide The Population Assessment of Tobacco and Health (PATH) Study- Focus Groups to Support Development of E-Cigarette and Hookah Questionnaire Items		 Form and Instruction
Form E.
Hookah Focus Group Moderator Guide - Online The Population Assessment of Tobacco and Health (PATH) Study- Focus Groups to Support Development of E-Cigarette and Hookah Questionnaire Items		 Form and Instruction
Form F.
Consent for Participation in a In-person Focus Group for the PATH Study The Population Assessment of Tobacco and Health (PATH) Study- Focus Groups to Support Development of E-Cigarette and Hookah Questionnaire Items		 Form and Instruction
B. Screener for E-cigarette and Hookah Focus focus group
B. E-cigarette hookah focus group screener 2-20-14.pdf 		Form and Instruction
C. E-Cigarette Focus Group Moderator Guide
C. E-cigarette moderators guide 2-20-14.pdf 		Form and Instruction
D, Hookah Moderator's Guide
D. Hookah moderators guide_in person 2-20-14.pdf 		Form and Instruction
E. Hookah Focus Group Moderator Guide - Online
E. Hookah moderators guide_online 2-20-14.pdf 		Form and Instruction
F. Consent for Participation in a In-person Focus Group for
F. In-person focus group consent form_2-20-14 (1).pdf 		Form and Instruction
E-cig Hookah Focus Groups -- the PATH Study Generic Clearance for Methodological Studies 2-20-14.docx
E-cig Hookah Focus Groups		IC Document
A. Recruitment materials 2-20-14.pdf
A. Recruitment Materials		IC Document
0675 PATH Generic E-cig Hookah ASPE Comments and PCB note 03.03.2014.doc
ASPE Comments		IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

Information Collection Instruments:
table that charts list of instruments
Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction B. Yes Yes Fillable Fileable
Form and Instruction C. Yes Yes Fillable Fileable
Form and Instruction D, Yes Yes Fillable Fileable
Form and Instruction E. Yes Yes Fillable Fileable
Form and Instruction F. Yes Yes Fillable Fileable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  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 218 0 0 0 0 0
Annual IC Time Burden (Hours) 115 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
E-cig Hookah Focus Groups 02/21/2014
A. Recruitment Materials 02/21/2014
ASPE Comments 03/03/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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