Outcome Follow-up Questionnaire in Person

Food and Drug Administration's Research and Evaluation Survey for the Public Education Campaign on Tobacco among LGBT (RESPECT)

OMB: 0910-0808

IC ID: 218389

Documents and Forms
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Outcome Follow-up Questionnaire in Person
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Follow Up Attacchment2_FollowUp_Instrument.docx Yes Yes Fillable Fileable
Other-Screener Attachment13_ScreenerwithInformedConsentForReturningParticipants.docx Yes Yes Fillable Printable

Health Consumer Health and Safety

 

2,364 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 2,364 0 0 0 0 2,364
Annual IC Time Burden (Hours) 1,578 0 0 0 0 1,578
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.

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