Information Collection

Recovery Campaign PSA Pretesting Focus Group Protocols

IC 252951 under ICR 202306-0990-006 · OMB 0990-0459.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0459 can be found here:

2024-02-07 - No material or nonsubstantive change to a currently approved collection
2023-12-19 - No material or nonsubstantive change to a currently approved collection

Documents and Forms

Document Name Document Type
Form SAMHSA PSA Recover Recovery Campaign PSA Pretesting Focus Group Protocols Form and Instruction
Form SAMHSA PSA Recover Recovery Campaign PSA Pretesting Focus Group Protocols Form and Instruction
SAMHSA PSA Recover SAMHSA PSA Recovery Focus Group Screener SAMHSA PSA Recovery Attachment B - Focus Group Screening Questionnaire _ Clean.docx Form and Instruction
SAMHSA PSA Recover SAMHSA PSA Recovery Focus Group Screener SAMHSA PSA Recovery Attachment B - Focus Group Screening Questionnaire _ Clean.docx Form and Instruction
SAMHSA PSA Recovery Justification Memo _ Clean.docx SAMHSA PSA Recovery Justification Memo _ Clean IC Document
SAMHSA PSA Recovery Justification Memo _ Clean.docx SAMHSA PSA Recovery Justification Memo _ Clean IC Document
SAMHSA PSA Recovery Attachment A - Focus Group Protocol _ Clean.docx SAMHSA PSA Recovery Attachment A - Focus Group Protocol IC Document
SAMHSA PSA Recovery Attachment A - Focus Group Protocol _ Clean.docx SAMHSA PSA Recovery Attachment A - Focus Group Protocol IC Document
SAMHSA PSA Recovery Attachment C - Focus Group Consent Form _ Clean.docx SAMHSA PSA Recovery Attachment C - Focus Group Consent Form IC Document
SAMHSA PSA Recovery Attachment C - Focus Group Consent Form _ Clean.docx SAMHSA PSA Recovery Attachment C - Focus Group Consent Form IC Document
SAMHSA PSA Recovery Attachment D - Focus Group Facilitator’s Guide _ Clean.docx SAMHSA PSA Recovery Attachment D - Focus Group Facilitator’s Guide IC Document
SAMHSA PSA Recovery Attachment D - Focus Group Facilitator’s Guide _ Clean.docx SAMHSA PSA Recovery Attachment D - Focus Group Facilitator’s Guide IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Recovery Campaign PSA Pretesting Focus Group Protocols	Agency IC Tracking Number:

IC Status: Unchanged

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
Form and Instruction	SAMHSA PSA Recovery Focus Group Screener	SAMHSA PSA Recovery Focus Group Screener	SAMHSA PSA Recovery Attachment B - Focus Group Screening Questionnaire _ Clean.docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Recovery Campaign PSA Pretesting Focus Group Protocols	FR Citation: 75 FR 28264

Number of Respondents: 1,802	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	1,802	1,802
Annual IC Time Burden (Hours)	150	150
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SAMHSA PSA Recovery Justification Memo _ Clean	SAMHSA PSA Recovery Justification Memo _ Clean.docx	04/19/2022
SAMHSA PSA Recovery Attachment A - Focus Group Protocol	SAMHSA PSA Recovery Attachment A - Focus Group Protocol _ Clean.docx	04/19/2022
SAMHSA PSA Recovery Attachment C - Focus Group Consent Form	SAMHSA PSA Recovery Attachment C - Focus Group Consent Form _ Clean.docx	04/19/2022
SAMHSA PSA Recovery Attachment D - Focus Group Facilitatorâs Guide	SAMHSA PSA Recovery Attachment D - Focus Group Facilitatorâs Guide _ Clean.docx	04/19/2022

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