Focus Group for Insider Knowledge:Get the Facts about Gynecologic Cancer

Focus Group Testing to Effectively Plan and Tailor Cancer Prevention and Control Communication Campaigns--New

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0800 can be found here:

Documents and Forms

Document Name Document Type
Focus Group for Insider Knowledge:Get the Facts about Gynecologic Cancer Form
Recruitment screener C1-1 GYN Consumer Screener 4 17 09.doc Form
2 Final Consumer Screener C1-1_GYN_Consumer_Screener_05_12_09.doc Form
C1-2 GYN Consumer Mod Guide 4 17 09.doc Focus Group Guide IC Document
C1-3 Participant Consent Form 4 17 09.doc Consent form IC Document
C1-2_GYN_Mod_Guide_05_11_09.doc Final Focus Group Guide IC Document
Terms of Clearance.pdf Terms of Clearance IC Document

Information Collection (IC) Details

IC Title:	Focus Group for Insider Knowledge:Get the Facts about Gynecologic Cancer	Agency IC Tracking Number:

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
Form	none	Recruitment screener	C1-1 GYN Consumer Screener 4 17 09.doc		No	No	Paper Only
Form	2	Final Consumer Screener	C1-1_GYN_Consumer_Screener_05_12_09.doc		No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 432	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	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	432	0	0	0	0	0
Annual IC Time Burden (Hours)	346	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Focus Group Guide	C1-2 GYN Consumer Mod Guide 4 17 09.doc	04/23/2009
Consent form	C1-3 Participant Consent Form 4 17 09.doc	04/23/2009
Final Focus Group Guide	C1-2_GYN_Mod_Guide_05_11_09.doc	05/26/2009
Terms of Clearance	Terms of Clearance.pdf	05/26/2009

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