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Focus Groups on Oncology Indications
Focus Groups About Drug Products As Used by The Food and Drug Administration
OMB: 0910-0677
IC ID: 235530
OMB.report
HHS/FDA
OMB 0910-0677
ICR 201703-0910-009
IC 235530
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0677 can be found here:
2020-01-10 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Focus Groups Screener Questionnaire.docx
Other-Survey Instrument
Consent Form.docx
Other-Consent Form
Disclosure Worksheet.docx
Other-Disclosure Worksheet
Terminology Worksheet.docx
Other-Terminology Worksheet
Terminology Moderator Guide.docx
Other-Terminology Moderator Guide
Endpoint Disclosure Moderator Guide.docx
Other-Endpoint Disclosure Moderator
0677 OMB Approval Memo Oncology Indication 2019.doc
OMB Approval Memo
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Focus Groups on Oncology Indications
Agency IC Tracking Number:
CDER
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-Survey Instrument
Focus Groups Screener Questionnaire.docx
Yes
Yes
Fillable Fileable
Other-Consent Form
Consent Form.docx
Yes
Yes
Fillable Fileable
Other-Disclosure Worksheet
Disclosure Worksheet.docx
Yes
No
Paper Only
Other-Terminology Worksheet
Terminology Worksheet.docx
Yes
No
Paper Only
Other-Terminology Moderator Guide
Terminology Moderator Guide.docx
Yes
No
Paper Only
Other-Endpoint Disclosure Moderator Guide
Endpoint Disclosure Moderator Guide.docx
Yes
No
Paper Only
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:
451
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
451
0
451
0
0
0
Annual IC Time Burden (Hours)
0
0
0
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
OMB Approval Memo
0677 OMB Approval Memo Oncology Indication 2019.doc
03/29/2019
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.