OMB control number

CDC Cervical Cancer Study (CX3)

OMB 0920-0814 · HHS/CDC.

OMB 0920-0814

Latest Forms, Documents, and Supporting Material

Document Name
Focus Groups with Health Care Providers Form
Follow-up Provider Survey Form
Follow-up Patient Survey Form
0920-0814_Part B_04 27 2012.docx Supporting Statement B
F2 Analysis tables revised.pdf Supplementary Document
G3 Certificate of Confidentiality.pdf Supplementary Document
G2 Battelle IRB Approval.pdf Supplementary Document
G1 CDC IRB approval.docx Supplementary Document
F1 Variables collected revised.docx Supplementary Document
E Medical Records Review.doc Supplementary Document
B2 Summary of Public Comments and CDC Response.pdf Supplementary Document
Attachment B1 Federal Register Notice.pdf Supplementary Document
A Authorizing Legislation.doc Supplementary Document
Att E2d_Script for reminder phone call_0209.doc Supplementary Document
Att E2a_Initial postcard_0209.doc Supplementary Document
Att E2c_Reminder postcard_0209.doc Supplementary Document
Att E2b_Cover letter patient follow-up survey_0209.doc Supplementary Document
Att E1c_HPV patient consent form not including patient survey_0209.doc Supplementary Document
Att Elb_HPV patient consent form including patient survey_0209.doc Supplementary Document
Att D2a_ Cover letter -- follow-up provider surveys_0209.doc Supplementary Document
C2a Consent Form for Provider Focus Group Interviews.docx Supplementary Document
C1a Cover Letter for Follow-up Provider Survey.docx Supplementary Document
D1e SCRIPT FOR REMINDER TELEPHONE CALL.doc Supplementary Document
D1d Reminder postcard.doc Supplementary Document
D1b Initial Postcard.doc Supplementary Document
D1c Cover Letter for Patient Follow-up Survey.docx Supplementary Document
D1a Patient Consent Survey.pdf Supplementary Document
0920-0814_Part A_04 27 2012.docx Supporting Statement A
Cx3 Study - Follow-up Patient Survey Other-WORD
Cx3 Study - Patient Enrollment Form Other-WORD
Cx3 Study - Patient Recruitment Other-WORD
Cx3 Study - Baseline Patient Survey Other-WORD
Cx3 Study - Follow-up Provider Survey Other-WORD
Focus Groups with Health Care Providers Form
Follow-up Provider Survey Form
Follow-up Patient Survey Form

All Historical Document Collections

201205-0920-008 Approved without change	Revision of a currently approved collection	2012-05-22
200903-0920-010 Approved without change	New collection (Request for a new OMB Control Number)	2009-03-31