Focus Group Research to Inform Consumer Food Safety Education and Outreach

Documents and Forms

Document Name Document Type
Appendix B_Food Recall_ModeratorGuide_11_30_20.pdf Other-food recall moderator guide
Appendix D_MCI_Moderator Guide__11_30_20.pdf Other-MCI moderator guide
Appendix A_Food Recall _Screener_11_30_20.docx food recall screener IC Document
Appendix C_MCI_Screener_11_30_20.docx MCI screener IC Document
Appendix E_Consent Form_Recall_12_17_20.docx consent form recall IC Document
Appendix F_Consent Form_MCI_12_17_20.docx consent form MCI IC Document
Appendix G_COVID consent addendum_12_17_20.docx COVID consent IC Document
Appendix H_COVID Day of screening tool_12_17_20.docx COVID day of screening IC Document
Appendix I_procedures COVID_12_17_20.docx procedures COVID IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Focus Group Research to Inform Consumer Food Safety Education and Outreach	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-food recall moderator guide			Appendix B_Food Recall_ModeratorGuide_11_30_20.pdf		No		Paper Only
Other-MCI moderator guide			Appendix D_MCI_Moderator Guide__11_30_20.pdf		No		Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 160	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	160	160
Annual IC Time Burden (Hours)	240	240
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
food recall screener	Appendix A_Food Recall _Screener_11_30_20.docx	12/08/2020
MCI screener	Appendix C_MCI_Screener_11_30_20.docx	12/08/2020
consent form recall	Appendix E_Consent Form_Recall_12_17_20.docx	12/22/2020
consent form MCI	Appendix F_Consent Form_MCI_12_17_20.docx	12/22/2020
COVID consent	Appendix G_COVID consent addendum_12_17_20.docx	12/22/2020
COVID day of screening	Appendix H_COVID Day of screening tool_12_17_20.docx	12/22/2020
procedures COVID	Appendix I_procedures COVID_12_17_20.docx	12/22/2020

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