PRAMS Opioid 2018 -Spanish

Collaborating Center for Questionnaire Design and Evaluation Research

OMB: 0920-0222

IC ID: 233753

Information Collection (IC) Details

View Information Collection (IC)

PRAMS Opioid 2018 -Spanish 0920-0222-19BY
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none PRAMS Opioid 2018 - Spanish Attach 1 Questionnaire 102318.docx Yes No Fillable Printable
Form none Telephone Screener - Spanish Attach 3 - Telephone Screener 102318.docx Yes No Fillable Printable
Form none Respondent Data Collection Sheet Attach 5 - Respondent Data Sheet 102318.docx Yes No Fillable Printable

Health Public Health Monitoring

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

98 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 98 0 98 0 0 0
Annual IC Time Burden (Hours) 34 0 34 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Letter to Dr. Schwab PRAMS Opioid 2018 10-day Spanish 102318.docx 10/29/2018
Recruitment Flyers Attach 2a-c Adv Flyers 102318.docx 10/29/2018
Consent Attach 4 - Informed Consent 102318.docx 10/29/2018
Thank you letter Attach 6 - Thank you letter 102318.docx 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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