TALK - Hispanic/Latino Focus Groups

Pretesting of Substance Abuse Prevention and Treatment and Mental Health Services Communications Messages

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0196 can be found here:

Documents and Forms

Document Name Document Type
Form Screener TALK - Hispanic/Latino Focus Groups Form and Instruction
Screener Screener 2016_2_5_UAD SPA PSA Screener_Attachment B.docx Form and Instruction
Guide Guide 2016_2_5_UAD SPA_Focus Group Guide_Attachment D.docx Form and Instruction
2016_2_5_UAD SPA_Consent Form_Attachment C.docx Consent Form IC Document
2016_2_5_OMB Package_UAD SPA_Focus Group.docx Justification IC Document
TransLet-6doc.doc Transmittal Letter IC Document
2016_2_5_OMB SPA_Focus Group Protocol_Attachment A.docx Protocol IC Document

Information Collection (IC) Details

IC Title:	TALK - Hispanic/Latino Focus Groups	Agency IC Tracking Number:

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 and Instruction	Screener	Screener	2016_2_5_UAD SPA PSA Screener_Attachment B.docx		Yes	Yes	Fillable Fileable
Form and Instruction	Guide	Guide	2016_2_5_UAD SPA_Focus Group Guide_Attachment D.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 48	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	48	48
Annual IC Time Burden (Hours)	64	64
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Consent Form	2016_2_5_UAD SPA_Consent Form_Attachment C.docx	02/18/2016
Justification	2016_2_5_OMB Package_UAD SPA_Focus Group.docx	02/18/2016
Transmittal Letter	TransLet-6doc.doc	02/18/2016
Protocol	2016_2_5_OMB SPA_Focus Group Protocol_Attachment A.docx	02/18/2016

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