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Federal forms, ICRs, and supporting documents

Information Collection

Cognitive Interview Screener and Interviews (Consumers); Screeners (Physicians and Consumers); Pretests (Physicians and Consumers); Main Study (Physicians and Consumers)

IC 259411 under ICR 202303-0910-023 · OMB 0910-0917.

Documents and Forms
Document Name
Document Type
Other-Screener-cognitive interviews
Other-Screener-cognitive interviews
Other-Screener-Pretest Main Study
Other-Screener-Pretest Main Study
Other-Consent form
Other-Consent form
Other-Questionnaire
Other-Questionnaire
Other-Interview Guide
Other-Interview Guide
Information Collection (IC) Details

View Information Collection (IC)

Cognitive Interview Screener and Interviews (Consumers); Screeners (Physicians and Consumers); Pretests (Physicians and Consumers); Main Study (Physicians and Consumers) CDER
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Screener-cognitive interviews Tradeoff Analysis Appendix A Screeners_Cognitive Interviews.docx Yes Yes Fillable Fileable
Other-Screener-Pretest Main Study Tradeoff Analysis Appendix B Screeners PretestMainStudy.docx Yes Yes Fillable Fileable
Other-Consent form Tradeoff Analysis Appendix C Consent Forms.docx Yes Yes Fillable Fileable
Other-Questionnaire Tradeoff Analysis Appendix D Questionnaires.docx Yes Yes Fillable Fileable
Other-Interview Guide Tradeoff Analysis Appendix E Interview Guide.docx Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

2,033 0
   
Individuals or Households
 
   100 %

  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 2,033 0 2,033 0 0 0
Annual IC Time Burden (Hours) 923 0 923 0 0 0
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.