OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Completes, Pretests Phase 1

IC 215727 under ICR 201510-0910-007 · OMB 0910-0791.

Documents and Forms
Document Name
Document Type
Other-Consumer Survey
Other-Consent Form Consumer
Other-Patient Email Invite
Information Collection (IC) Details

View Information Collection (IC)

Completes, Pretests Phase 1 CDER
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Consumer Survey Consumer Questionnaire Revised 0791 10-14-2015.docx Yes Yes Fillable Fileable Signable
Other-Consent Form Consumer CONSENT FORM CONSUMER 3-17-25.doc Yes Yes Fillable Fileable Signable
Other-Patient Email Invite PATIENT EMAIL INVITE 3-17-15.docx Yes No Printable Only

Health Consumer Health and Safety

 

400 0
   
Individuals or Households
 
   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 400 0 0 0 0 400
Annual IC Time Burden (Hours) 200 0 0 0 0 200
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.