CATI Recruitment

Use of Smartphones to Collect Information about Health Behaviors: Feasibility Study

Documents and Forms

Document Name Document Type
CATI Recruitment Form
CATI Survey Appendix D. Initial CATI Survey.docx Form
Appendix C2. CATI Informed Consent Statement.doc Informed Consent - CATI IC Document

Information Collection (IC) Details

IC Title:	CATI Recruitment	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	CATI Survey	Appendix D. Initial CATI Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,590	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,590	1,590
Annual IC Time Burden (Hours)	186	186
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Informed Consent - CATI	Appendix C2. CATI Informed Consent Statement.doc	04/17/2013

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