OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Focus Groups with Rural Youth to Test Strategic Concepts Designed to Prevent Youth Smokeless Tobacco Use

IC 210333 under ICR 201406-0910-011 · OMB 0910-0674.

Documents and Forms
Document Name
Document Type
Other-Parental Consent Form
Other-Youth Assent
Other-Concept Ranking Sheet
Other-Discussion Guide
Other-Homework
Other-Image Matching Sheet
Other-Participant Rating Sheet
Other-Screner Document
Other-Image Matching Stimuli
Other-Strategic Concept Stimuli
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Focus Groups with Rural Youth to Test Strategic Concepts Designed to Prevent Youth Smokeless Tobacco Use
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Parental Consent Form Rural Smokeless Strategic Concepts FG_Parental Consent Form.docx Yes Yes Fillable Printable
Other-Youth Assent Rural Smokeless Strategic Concepts FG_Youth Assent Form.docx Yes Yes Fillable Printable
Other-Concept Ranking Sheet Rural Strategic Concept FG_Concept Ranking Sheet_OMB.PDF Yes Yes Fillable Printable
Other-Discussion Guide Rural Strategic Concept FG_Discussion Guide.docx Yes Yes Fillable Printable
Other-Homework Rural Strategic Concept FG_Homework.docx Yes Yes Fillable Fileable
Other-Image Matching Sheet Rural Strategic Concept FG_Image Matching Sheet_OMB.PDF Yes Yes Fillable Printable
Other-Participant Rating Sheet Rural Strategic Concept FG_Participant Rating Sheet_OMB.PDF Yes Yes Fillable Printable
Other-Screner Document Rural Strategic Concept FGs_Screener.docx Yes Yes Fillable Printable
Other-Image Matching Stimuli Rural Strategic Concept FG_Image Matching Stimuli.pdf Yes Yes Printable Only
Other-Strategic Concept Stimuli Rural Strategic Concept FG_Strategic Concept Stimuli.pdf Yes Yes Printable Only

Health Immunization Management

 

128 0
   
Individuals or Households
 
   0 %

  Requested 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 128 0 0 0 0 128
Annual IC Time Burden (Hours) 256 0 0 0 0 256
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Rural Strategic Concept FG_OMB Memo_2_7_14 Rural Strategic Concept FG_OMB Memo_2_7_14.doc 02/07/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.