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Recruitment of Human Subjects for Driver Monitoring of Inattention and Impairment Using Vehicle Equipment (DrIIVE)
Recruitment of Human Subjects for Driver Monitoring of Inattention and Impairment Using Vehicle Equipment (DrIIVE)
OMB: 2127-0701
IC ID: 208853
OMB.report
DOT/NHTSA
OMB 2127-0701
ICR 201309-2127-003
IC 208853
( )
Documents and Forms
Document Name
Document Type
Form NHTSA Form 1222
Recruitment of Human Subjects for Driver Monitoring of Inattention and Impairment Using Vehicle Equipment (DrIIVE)
Form
3- Pre-Visit Activity Log.doc
Other-Activity Log
5- Pre-Drive and Post-Drive Stanford Sleepiness Scale.doc
Other-Sleepiness Rating Scale
NHTSA Form 1222 Recruitment Questionnaire
1- Recrutiment Questionnaire.doc
Form
NHTSA Form 1223 Pre-Drive Sleep and Intake Questionnaire
2- Pre-Drive Sleep and Intake Questionnaire.doc
Form
NHTSA Form 1219 Morning Evening Questionnaire
4- Morning Evening Questionnaire.doc
Form
NHTSA Form 1221 Retrospective Sleepiness
6- RetrospectiveSleepiness_S1R.doc
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Recruitment of Human Subjects for Driver Monitoring of Inattention and Impairment Using Vehicle Equipment (DrIIVE)
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
NHTSA Form 1222
Recruitment Questionnaire
1- Recrutiment Questionnaire.doc
No
Fillable Printable
Form
NHTSA Form 1223
Pre-Drive Sleep and Intake Questionnaire
2- Pre-Drive Sleep and Intake Questionnaire.doc
No
Fillable Printable
Other-Activity Log
3- Pre-Visit Activity Log.doc
No
Fillable Printable
Form
NHTSA Form 1219
Morning Evening Questionnaire
4- Morning Evening Questionnaire.doc
No
Fillable Printable
Other-Sleepiness Rating Scale
5- Pre-Drive and Post-Drive Stanford Sleepiness Scale.doc
No
Fillable Printable
Form
NHTSA Form 1221
Retrospective Sleepiness
6- RetrospectiveSleepiness_S1R.doc
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Transportation
Subfunction:
Ground Transportation
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
168
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
168
0
168
0
0
0
Annual IC Time Burden (Hours)
247
0
247
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.