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
Other-Video Storyboards
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 08 Script for Recruiting Intercept Participants_FU6.docx No   Printable Only
Other-Screener Informed Consent Attachment 05 CrossSectional Screener Inf Con_FU6.docx Yes Yes Fillable Fileable
Other-Screener Attachment 03 New Participant Screener_FU6.docx Yes Yes Fillable Fileable
Other-Video Storyboards Attachment 02b Video Storyboards FU6.docx Yes No Printable Only

Health Consumer Health and Safety

 

11,239 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 11,239 0 0 1,984 0 9,255
Annual IC Time Burden (Hours) 933 0 0 165 0 768
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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