OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Adoption, Health Impact and Cost of Smoke-Free Multi-Unit Housing Policies

OMB 0920-1004 · HHS/CDC.

OMB 0920-1004

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Focus Group GuideForm
Resident Pre-Focus Group SurveyForm
Focus Group ScreenerForm
Saliva CollectionForm and Instruction
Resident Survey Post-int - children's module section G SpanishForm
Resident Survey Post-int- children's module section GForm
Resident Survey - Post-interventionForm
Resident Surevy Post-intervention SpanishForm
MUH Resident Baseline - Children's Module section G SpanishForm
MUH Resident Baseline - Children's Module section GForm
MUH Resident Baseline - Core - sections A-F SpanishForm
MUH Resident Baseline - Core - sections A-FForm
MUH Resident Survey - LA (Spanish)Form
MUH Resident Survey - LA (English)Form
MUH Operator Post Intervention Survey - LA, ME, MN, FLForm
7A - MUH operator post-intervention survey - LA countyForm
Recruitment phone script MN, ME, FLForm and Instruction
MUH Operator Baseline Survey - MN, ME, FLForm
MUH Operator Baseline SurveyForm
Recruitment Script LAForm
clean 12 17 13 MUH SS Part B 09 19 13.docSupporting Statement B
Att 14_CDC IRB Approval renewal 5.13.13.docx Supplementary Document
revised 12.17.13 Att 3D Logic Model_8 27 2012 9.3.13_updated.doc Supplementary Document
clean 12.17.13 Att 3C_Data Collection Flow Chart 9.3.13.doc Supplementary Document
clean 12.17.13 Att 3B_Sources of Survey Questions 9.3.13.doc Supplementary Document
clean 12.17.13 Att 3A_Effect Sizes 9.3.13.doc Supplementary Document
Att 2B_Summary of Public Comments.doc Supplementary Document
Att 2A_Federal Register Notice.pdf Supplementary Document
Att 1D_PPHF.PDF Supplementary Document
Att 1C_Affordable Care Act.pdf Supplementary Document
Att 1B_PHSA.DOCX Supplementary Document
Att 1A_ARRA of 2009.pdf Supplementary Document
Att 13A-1_Focus Group Consent_9.3.13.docx Supplementary Document
Att 13A-1_Focus Group Consent_9.3.13.docx Supplementary Document
Att 13A-1_Focus Group Consent_9.3.13.docx Supplementary Document
Att 12A-1_Focus Group Recruitment Flyer.docx Supplementary Document
Att 12A-2(e) Other Focus Group Recruitment Materials_9.3.13.docx Supplementary Document
clean 12.17.13 Att 10-A1(e)_MUH Child Assent for Saliva 5_16_13.docx Supplementary Document
clean 12 13 13 Att 10-A1(s)_MUH Child Assent for Saliva 5_16_13.docx Supplementary Document
Att 11A_Protocol for Air Monitoring.doc Supplementary Document
clean 12 17 13 Att 8A-3(s) LA Resident Consent for Child Questions_9 3 1....docx Supplementary Document
Att 8A-3(e) LA Resident Consent for Child Questions_9.3.13.docx Supplementary Document
Att 8A-2(s) MUHAdult Resident HIPPA form 9.3.13.docx Supplementary Document
Att 8A-2(e) MUHAdult Resident HIPPA form_9.3.13.docx Supplementary Document
clean 12 17. 13 Att 8A-1(s) MUH Resident Adult Participant Consent_9 3 1....docx Supplementary Document
clean 12.17.13 Att 8A-1(e) MUH Resident Adult Participant Consent_9.3.......docx Supplementary Document
clean 12 13 13 Att 8A-4(s)_Resident Recruitment Materials_9 3 13.docx Supplementary Document
clean 12.17.13 Att 8A-4(e)_Resident Recruitment Materials_9.3.13.docx Supplementary Document
Att 8A-3(s) LA Resident Consent for Child Questions_9.3.13.docx Supplementary Document
clean 12.17.13 Att 8A-3(e) LA Resident Consent for Child Questions_9.3......docx Supplementary Document
Att 8A-2(s) MUHAdult Resident HIPPA form 9.3.13.docx Supplementary Document
Att 8A-2(e) MUHAdult Resident HIPPA form_9.3.13.docx Supplementary Document
clean 12.17.13 Att 8A-1(e) MUH Resident Adult Participant Consent_9.3.......docx Supplementary Document
Att 8A-1(s) MUH Resident Adult Participant Consent 9.3.13.docx Supplementary Document
clean 12.17.13 Att 6A-2(e) MUH Operator Survey Consent MN ME FL_9.3.13 c....docx Supplementary Document
Att 6A-1(e) MUH Operator Consent LA_9.3.13.docx Supplementary Document
clean 12.17.13 Att 4A-1(e) Letter to Property Management_9.3.13.docx Supplementary Document
clean 12.17.13 MUH SS Part A 09 19 13.docxSupporting Statement A
Resident Focus Group Guide - Outcome Oriented Instruction
Resident Focus Group Guide - Process Oriented Form
Resident Pre-Focus Group Survey Form
Resident Focus Group Screening Form
MUH Saliva Collection - children Instruction
MUH Resident Air Quality Monitoring Instruction
MUH Resident Saliva Collection Form and Instruction
MUH Resident Post-intervention Children's Module - LA Form
MUH Resident Post-intervention Children's Module - LA Form
MUH Resident Post-intervention Survey - Core LA Form
MUH Resident Post-intervention Survey - Core LA Form
MUH Resident Baseline Survey - Children's Module LA Form
MUH Resident Baseline Survey - Children's Module LA Form
MUH Resident Baseline Survey - Core LA Form
MUH Resident Baseline Survey - Core LA Form
MUH Resident Baseline Survey - screening LA Form
MUH Resident Baseline Survey - screening LA Form
MUH operators post-intervention survey - MN, ME, FL Form
MUH Operator Post-intervention Survey - LA county Form
Phone script for recruitment of MUH operators - MN, ME, FL Form and Instruction
MUH Operator Baseline Survey - MN, ME, FL Form
MUH Operator Baseline Survey (LA County) Form
Phone script for Recruitment of MUH operators in LA Form

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
201309-0920-011 New collection (Request for a new OMB Control Number) 2013-09-30 Approved with change
201210-0920-003 New collection (Request for a new OMB Control Number) 2012-10-10 Improperly submitted