OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Adult - Survey

IC 236787 under ICR 202003-0910-009 · OMB 0910-0880.

Documents and Forms
Document Name
Document Type
Other-Online Survey Adult Consent Fo
Other-Online Survey Questionnaire
Other-Online Survey Adult Invitation
Information Collection (IC) Details

View Information Collection (IC)

Adult - Survey
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Online Survey Questionnaire Appendix K HPHC2 Online Survey Questionnaire_CLEAN_3.20.docx Yes Yes Fillable Fileable Signable
Other-Online Survey Adult Invitation Reminder Email Appendix Q HPHC2 Online Survey Adult Reminder Email_CLEAN_2.20.docx Yes Yes Fillable Printable
Other-Online Survey Adult Consent Form Appendix G HPHC2 Online Survey Adult Consent Form_CLEAN_3.20.docx Yes Yes Fillable Fileable Signable

Health Consumer Health and Safety

 

3,300 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 3,300 0 300 0 0 3,000
Annual IC Time Burden (Hours) 1,100 0 100 0 0 1,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.