Rapid Message Testing with Consumer Panel - Vaccines and Seniors Brochure

Data to Support Drug Product Communications

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0695 can be found here:

Documents and Forms

Document Name Document Type
Recruiting Screener.docx Other-Survey
Informed Consent Form.docx Other-Consent Form
Vaccines and Seniors Trifold Brochure.pdf Other-Brochure
0695 OMB approval memo for Vaccines and Seniors Brochure.docx OMB approval memo IC Document

Information Collection (IC) Details

IC Title:	Rapid Message Testing with Consumer Panel - Vaccines and Seniors Brochure	Agency IC Tracking Number:	OC

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey	Recruiting Screener.docx	Yes	No	Paper Only
Other-Consent Form	Informed Consent Form.docx	Yes	No	Paper Only
Other-Brochure	Vaccines and Seniors Trifold Brochure.pdf	Yes	No	Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 250	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	250	250
Annual IC Time Burden (Hours)	20	20
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
OMB approval memo	0695 OMB approval memo for Vaccines and Seniors Brochure.docx	05/02/2018

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