P7. Cognitive Testing Participant SCREENER

National Youth Tobacco Surveys (NYTS) 2015-2017

OMB: 0920-0621

IC ID: 229816

Information Collection (IC) Details

View Information Collection (IC)

P7. Cognitive Testing Participant SCREENER
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-0621 Cognitive Testing Participant Screener P7_Youth Screener_4.25.2018_CLEAN_3.docx No   Fillable Fileable

Health Public Health Monitoring

 

300 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 300 0 0 0 0 300
Annual IC Time Burden (Hours) 40 0 0 0 0 40
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
P2. Cognitive Interview Assent Form P2_Youth Under 18 Assent Form_4.16.2018_CLEAN_2.docx 04/25/2018
P3. Cognitive Interview Consent Form P3_Youth 18 yo Consent_4.16.2018_CLEAN_2.docx 04/25/2018
P4. Cognitive Testing Parental Permission P4_Youth Under 18 Parental Permission_4.16.2018 rbk_IA_AG_CLEAN_2.docx 04/25/2018
P5. Youth Materials: ENDS KEY FACTS P5_Youth Materials_ENDS Key Facts_no_tracked_changes.pdf 04/25/2018
P6. Youth Matrerials: smokefreeteen Tools for Quitting P6_Youth Materials_Tools for Quitting_no_tracked_changes.pdf 04/25/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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