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Faculty Interview and Email Request
Research Mentoring Dyad Study
OMB: 0990-0357
IC ID: 191869
OMB.report
HHS/HHSDM
OMB 0990-0357
ICR 201001-0990-002
IC 191869
( )
Documents and Forms
Document Name
Document Type
0990- (Dyad) FacultyEmailInvitationsAppendixC 1 A.doc
Other-Email Invitations
0990- (Dyad) FACULTY TELEPHONE RECRUITMENT SCRIPTAppendixC 2 A.doc
Other-Telephone recruitment
0990-(Dyad) FacultyInterviewProtocols 6AppendixB 3 A.doc
Other-Interview Protocols
0990- (Dyad)SampleConfirmationMessageAPPENDIX C 4.doc
0990- (Dyad)SampleConfirmationMessageAPPENDIX C 4
IC Document
0990- (Dyad) FacultyFrequentlyAskedQuestionAppendixC 5 A.doc
Faculty Frequent questions
IC Document
0990- (Dyad) FacultyConsentFormsAPPENDIX C 6 A.doc
Faculty-Consent Forms
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Faculty Interview and Email Request
Agency IC Tracking Number:
Is this a Common Form?
No
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-Email Invitations
0990- (Dyad) FacultyEmailInvitationsAppendixC 1 A.doc
Yes
Yes
Paper Only
Other-Telephone recruitment
0990- (Dyad) FACULTY TELEPHONE RECRUITMENT SCRIPTAppendixC 2 A.doc
No
No
Paper Only
Other-Interview Protocols
0990-(Dyad) FacultyInterviewProtocols 6AppendixB 3 A.doc
No
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
100
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
100
0
100
0
0
0
Annual IC Time Burden (Hours)
200
0
200
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
0990- (Dyad)SampleConfirmationMessageAPPENDIX C 4
0990- (Dyad)SampleConfirmationMessageAPPENDIX C 4.doc
12/22/2009
Faculty Frequent questions
0990- (Dyad) FacultyFrequentlyAskedQuestionAppendixC 5 A.doc
12/22/2009
Faculty-Consent Forms
0990- (Dyad) FacultyConsentFormsAPPENDIX C 6 A.doc
12/23/2009
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.