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Federal forms, ICRs, and supporting documents

Information Collection

Electronic Nicotine Delivery Systems Formative Data Collection to Inform Experimenter and Established User Definitions

IC 235300 under ICR 201907-0910-006 · OMB 0910-0810.

Documents and Forms
Document Name
Document Type
Other-Study Screener
Other-Study Questionnaire
Other-Parental Recruitment Email
Other-Parent Permission
Other-Youth Assent
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Electronic Nicotine Delivery Systems Formative Data Collection to Inform Experimenter and Established User Definitions CTP
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Study Screener Attachment A SurveyENDS_StudyScreener.docx Yes No Paper Only
Other-Study Questionnaire Attachment B SurveyENDS_Study Questionnaire.docx Yes Yes Fillable Fileable
Other-Parental Recruitment Email Attachment C SurveyENDS_ParentRecruitmentEmail.docx Yes No Paper Only
Other-Parent Permission Attachment D SurveyENDS_ParentPermission.docx Yes No Paper Only
Other-Youth Assent Attachment E SurveyENDS_YouthAssent.docx Yes No Paper Only

Health Consumer Health and Safety

 

15,110 0
   
Individuals or Households
 
   100 %

  Requested 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 15,110 0 0 0 0 15,110
Annual IC Time Burden (Hours) 1,191 0 0 0 0 1,191
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement Part A - Electronic Nicotine Delivery Systems SS Part A ENDSPrimaryDataCollection.docx 03/12/2019
Supporting Statement Part B - Electronic Nicotine Delivery Systems SS Part B ENDSPrimaryDataCollection.docx 03/12/2019
Approval Letter Attachment F ApprovalLetter_RTI-IRB_STUDY00020494_20494.pdf 03/12/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.