OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Screener, Pretest and Main Study: Consumers and Primary Care Physicians

IC 259758 under ICR 202304-0910-006 · OMB 0910-0916.

Documents and Forms
Document Name
Document Type
Other-Questionnaire
Other-Questionnaire
Other-Screener
Other-Screener
Other-Informed consent
Other-Informed consent
Information Collection (IC) Details

View Information Collection (IC)

Screener, Pretest and Main Study: Consumers and Primary Care Physicians CDER
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Questionnaire Appendix A - Questionnaire FINAL.docx Yes Yes Fillable Fileable
Other-Screener SSB Med Tracking FINAL.docx Yes Yes Fillable Fileable
Other-Informed consent Appendix C - Informed Consent FINAL.docx Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

1,360 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 1,360 0 1,360 0 0 0
Annual IC Time Burden (Hours) 373 0 373 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.