[OPHDST] Foundational User Interviews with the Public

[OS] CDC/ATSDR Formative Research and Tool Development

OMB: 0920-1154

IC ID: 272084

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

[OPHDST] Foundational User Interviews with the Public 0920-1154-25AB
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1154 Foundational Screener (25AB) Att 1 Foundational.docx Yes Yes Fillable Fileable
Form and Instruction 0920-1154 Foundational Data Collection Interview Scripts (25AB) Att 2 Foundational.docx Yes No Fillable Fileable

Health Illness Prevention

 

60 0
   
Individuals or Households
 
   100 %

  Requested 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 120 0 0 0 0 120
Annual IC Time Burden (Hours) 65 0 0 0 0 65
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA (25AB) SSA Foundational.docx 11/01/2024
SSB (25AB) SSB Foundational.docx 11/01/2024
Template Foundational (25AB) 0920-1154 Template Foundational.docx 11/01/2024
Project Determination (25AB) Att 3 Foundational.pdf 11/01/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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