PRAMS Opioid 2018 - English

Collaborating Center for Questionnaire Design and Evaluation Research

OMB: 0920-0222

IC ID: 233751

Information Collection (IC) Details

View Information Collection (IC)

PRAMS Opioid 2018 - English 0920-0222-19BU
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none PRAMS Opioid 2018 Attach 1 Questionnaire 091918.docx Yes No Fillable Printable
Form none Telephone Screener Attach 3 - Telephone Screener 091918.docx Yes No Fillable Printable
Form none Respondent Data Sheet Attach 5 - Resp Data Collect Sheet 091918.doc Yes No Fillable Printable

Health Public Health Monitoring

Health and Demographic Surveys Conducted in Probability Samples of the US Population  49 FR 37693

176 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 176 0 176 0 0 0
Annual IC Time Burden (Hours) 68 0 68 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Letter to Dr. Schwab PRAMS Opioid English 2018 10-day 101718.docx 10/29/2018
Recruitment Flyers Attach 2a-c - Ad-flyer.doc 10/29/2018
Consent Attach 4 - Informed Consent 091918.docx 10/29/2018
Thank you letter Attach 6 - Thank you letter.doc 10/29/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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