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Main Study Screener (Acne)
Experimental Study of Direct-to-Consumer Promotion Directed at Adolescents
OMB: 0910-0778
IC ID: 212877
OMB.report
HHS/FDA
OMB 0910-0778
ICR 201408-0910-005
IC 212877
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0778 can be found here:
2015-10-01 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
APPENDIX A QUESTIONNAIRE 7-25-2014.docx
Other-Questionnaire
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Main Study Screener (Acne)
Agency IC Tracking Number:
CDER
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
Other-Questionnaire
APPENDIX A QUESTIONNAIRE 7-25-2014.docx
Yes
Yes
Fillable Fileable Signable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
7,142
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
7,142
0
7,142
0
0
0
Annual IC Time Burden (Hours)
571
0
571
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.