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Pilot of in-person Recruitment
Food and Drug Administration's Research and Evaluation Survey for the Public Education Campaign on Tobacco among LGBT (RESPECT)
OMB: 0910-0808
IC ID: 218381
OMB.report
HHS/FDA
OMB 0910-0808
ICR 201707-0910-017
IC 218381
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0808 can be found here:
2018-12-12 - Revision of a currently approved collection
2018-07-26 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Attachment8_ScriptforRecruitingInterceptParticipants FU2.docx
Other-Script for Recruiting Particip
Attachment13_ScreenerwithInformedConsentForLongitudinalParticipants FU2.docx
Other-Screener Informed Consent
Attachment3_Screener.docx
Other-Screener
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Pilot of in-person Recruitment
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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-Script for Recruiting Participants
Attachment8_ScriptforRecruitingInterceptParticipants FU2.docx
No
Printable Only
Other-Screener Informed Consent
Attachment13_ScreenerwithInformedConsentForLongitudinalParticipants FU2.docx
Yes
Yes
Fillable Fileable
Other-Screener
Attachment3_Screener.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
27
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
90 %
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
27
0
0
0
0
27
Annual IC Time Burden (Hours)
2
0
0
0
0
2
Annual IC Cost Burden (Dollars)
0
0
0
0
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.