Information Collection

Dietary Supplement Education Focus Groups (Formative Research) (CFSAN

IC 239982 under ICR 201911-0910-015 · OMB 0910-0497.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0497 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix I - Screener Older Adults.docx	Other-Participant Screener - Older A
Appendix II - Screener for Younger Adults.docx	Other-Participant Screener - Young A
Appendix III- Moderator Guide for Older Adults.docx	Other-Moderator Guide - Older Adults
Appendix IV - Moderator Guide for Young Adults.docx	Other-Moderator Guide - Young Adults
Appendix V - Older Adult Fact Sheet.docx	Other-Fact Sheet - Older Adult
Appendix VI - Education Info for Young Adult Population.docx	Other-Fact Sheet - Young Adult
Consent Form.docx	Other-Consent Form
Confirmation Email to Participants.docx	Other-Confirmation Email
0497 OMB Approval Memo Dietary Supplement 2020.docx 0497 OMB Approval Memo	IC Document

IC Title:

Dietary Supplement Education Focus Groups (Formative Research) (CFSAN

Agency IC Tracking Number:

CFSAN

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Participant Screener - Older Adults	Appendix I - Screener Older Adults.docx	Yes	No	Paper Only
Other-Participant Screener - Young Adults	Appendix II - Screener for Younger Adults.docx	Yes	No	Paper Only
Other-Moderator Guide - Older Adults	Appendix III- Moderator Guide for Older Adults.docx	Yes	No	Paper Only
Other-Moderator Guide - Young Adults	Appendix IV - Moderator Guide for Young Adults.docx	Yes	No	Paper Only
Other-Fact Sheet - Older Adult	Appendix V - Older Adult Fact Sheet.docx	Yes	No	Paper Only
Other-Fact Sheet - Young Adult	Appendix VI - Education Info for Young Adult Population.docx	Yes	No	Paper Only
Other-Consent Form	Consent Form.docx	Yes	No	Paper Only
Other-Confirmation Email	Confirmation Email to Participants.docx	Yes	No	Printable Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,360

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,360	1,360
Annual IC Time Burden (Hours)	368	368
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
0497 OMB Approval Memo	0497 OMB Approval Memo Dietary Supplement 2020.docx	02/14/2020

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