Adolescents (Wave Two)

CLINICAL MYTH-TERIES: A VIDEO GAME ABOUT CLINICAL STUDIES (NHLBI)

Documents and Forms

Document Name Document Type
Form 4 Adolescents (Wave Two) Form and Instruction
4 Screen Pre Post Evaluation Attachment 5 - Screen pre post eval.docx Form and Instruction
5 Screenshots of the Pre Post Evaluation Attachment 8 - Screenshots of Pre Post Evaluations.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Adolescents (Wave Two)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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 and Instruction	4	Screen Pre Post Evaluation	Attachment 5 - Screen pre post eval.docx		No	No	Paper Only
Form and Instruction	5	Screenshots of the Pre Post Evaluation	Attachment 8 - Screenshots of Pre Post Evaluations.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 250	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	250	250
Annual IC Time Burden (Hours)	333	333
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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