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(CDER) Focus Groups Examining Consumer Reporting of Adverse Events
FDA Focus Groups and Interviews
OMB: 0910-0497
IC ID: 267658
OMB.report
HHS/FDA
OMB 0910-0497
ICR 202310-0910-007
IC 267658
( )
Documents and Forms
Document Name
Document Type
Attachment A. Screener.docx
Other-Screener
Attachment B. Recruitment Flyer.docx
Other-Recruitment Flyer
Attachment C. Confirmation Letter.docx
Other-Confirmation Letter
Attachment D. Reminder Letter.docx
Other-Reminder Letter
Attachment E. Informed Consent.docx
Other- Informed Consent
Attachment F. Moderator Guide.docx
Other- Moderator Guide
0497 OMB Memo_Examining Consumer Reporting of AE 2024.docx
Gen IC Memo
IC Document
IRB Letter.pdf
IRB Letter
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
(CDER) Focus Groups Examining Consumer Reporting of Adverse Events
Agency IC Tracking Number:
CDER
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-Screener
Attachment A. Screener.docx
Yes
Yes
Fillable Fileable
Other-Recruitment Flyer
Attachment B. Recruitment Flyer.docx
No
Printable Only
Other-Confirmation Letter
Attachment C. Confirmation Letter.docx
Yes
No
Printable Only
Other-Reminder Letter
Attachment D. Reminder Letter.docx
Yes
No
Printable Only
Other- Informed Consent
Attachment E. Informed Consent.docx
Yes
No
Fillable Fileable
Other- Moderator Guide
Attachment F. Moderator Guide.docx
No
Printable Only
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:
150
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
150
0
150
0
0
0
Annual IC Time Burden (Hours)
114
0
114
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Gen IC Memo
0497 OMB Memo_Examining Consumer Reporting of AE 2024.docx
05/14/2024
IRB Letter
IRB Letter.pdf
05/14/2024
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.