Information Collection

American Academy of Pediatrics Oral Health Toolkit Research and Message Testing

IC 228002 under ICR 201502-0920-001 · OMB 0920-0572.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0572 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
ATTACHMENT B FG Guide New and Expectant Mothers_081017.docx	Other-Focus Group Guide
HMTS_Expedited_Review_Form_cb_Revised_081017.docx HTMS Review Form	IC Document
ATTACHMENT A Informed Consent form rbk 082317.docx Consent	IC Document
ATTACHMENT C Materials for testing_081017.docx Materials for Testing	IC Document

IC Title:

American Academy of Pediatrics Oral Health Toolkit Research and Message Testing

Agency IC Tracking Number:

0920-0572-17AZY

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Focus Group Guide			ATTACHMENT B FG Guide New and Expectant Mothers_081017.docx		Yes	No	Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 40

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	40	40
Annual IC Time Burden (Hours)	60	60
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
HTMS Review Form	HMTS_Expedited_Review_Form_cb_Revised_081017.docx	08/28/2017
Consent	ATTACHMENT A Informed Consent form rbk 082317.docx	08/28/2017
Materials for Testing	ATTACHMENT C Materials for testing_081017.docx	08/28/2017

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