Screening and Consent Process (Phase 2Survey)

Evaluation of the National Tobacco Prevention and Control Public Education Campaign

OMB: 0920-0923

IC ID: 200737

Information Collection (IC) Details

View Information Collection (IC)

Screening and Consent Process (Phase 2Survey)
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction None Evaluation of the National Tobacco Prevention and Control Public Education Screening Questionnaire Att E-1. Revised Screener 6-11-13.docx Yes Yes Fillable Printable

Health Immunization Management

 

43,737 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 43,737 0 0 0 0 43,737
Annual IC Time Burden (Hours) 1,458 0 0 0 0 1,458
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Att F-1. KN Recruitment Procedures Att F-1. KN Recruitment Procedures.DOC 02/07/2013
Att E-2. Email Notification and Reminders Att E-2. Email Notification and Reminders.doc 02/04/2013
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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