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

Documents and forms in this information collection
Document Name	Document Type
Tradeoff Analysis Appendix A Screeners_Cognitive Interviews.docx	Other-Screener-cognitive interviews
Tradeoff Analysis Appendix A Screeners_Cognitive Interviews.docx	Other-Screener-cognitive interviews
Tradeoff Analysis Appendix B Screeners PretestMainStudy.docx	Other-Screener-Pretest Main Study
Tradeoff Analysis Appendix B Screeners PretestMainStudy.docx	Other-Screener-Pretest Main Study
Tradeoff Analysis Appendix C Consent Forms.docx	Other-Consent form
Tradeoff Analysis Appendix C Consent Forms.docx	Other-Consent form
Tradeoff Analysis Appendix D Questionnaires.docx	Other-Questionnaire
Tradeoff Analysis Appendix D Questionnaires.docx	Other-Questionnaire
Tradeoff Analysis Appendix E Interview Guide.docx	Other-Interview Guide
Tradeoff Analysis Appendix E Interview Guide.docx	Other-Interview Guide

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

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

Agency IC Tracking Number:

CDER

Is this a Common Form? No

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-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

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,033

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,033	2,033
Annual IC Time Burden (Hours)	923	923
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.