General population – outcome screener (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: 218387

Documents and Forms
Document Name
Document Type
Other-Script for Recruiting Intercep
Other-Screener Informed Consent
Other-Screener
Information Collection (IC) Details

View Information Collection (IC)

General population – outcome screener (in person)
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Script for Recruiting Intercept Participants Attachment 8 Script for Recruiting Intercept Participants_FU4.docx No   Printable Only
Other-Screener Informed Consent Attachment 5 CrossSectional Screener Inf Con FU3.docx Yes Yes Fillable Fileable
Other-Screener Attachment 3 New Participant Screener_FU4.docx Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

7,271 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 7,271 0 0 1,212 0 6,059
Annual IC Time Burden (Hours) 605 0 0 101 0 504
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.

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