OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Phase IV Follow-up CAWI Survey, CATI Script or Paper/Pen

IC 220928 under ICR 201604-0925-001 · OMB 0925-0406.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Phase IV Follow-up CAWI Survey, CATI Script or Paper/Pen
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 23 Attachment 25-1 AHS Phase IV Health Follow-up CAWI Participant Survey Attachment 25-1. AHS Phase IV Health Follow-Up CAWI Participant Survey.pdf Yes No Fillable Fileable
Form and Instruction 24 Attachment 25-2 AHS Phase IV Health Follow-up CATI Proxy Survey Script Attachment 25-2. AHS Phase IV Health Follow-Up CATI Participant Survey Script.pdf Yes No Fillable Fileable
Form and Instruction 25 Attachment 25-3 AHS Phase IV Health Follow-up Paper & Pen Participant Survey Attachment 25-3 AHS Phase IV Health Follow-Up Paper & Pen Participant Survey.pdf Yes No Fillable Fileable

Health Health Care Services

09-25-0200 Clinical, Basic and Population-based Research Studies  67 FR 60776

10,201 0
   
Individuals or Households
 
   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 10,201 0 10,201 0 0 0
Annual IC Time Burden (Hours) 4,250 0 4,250 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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