OMB control number

Test Predictability of Falls Screening Tools

OMB 0920-1220 · HHS/CDC.

OMB 0920-1220

Latest Forms, Documents, and Supporting Material

Document Name
Proxy Survey Phone Mode Form and Instruction
Proxy Survey Web Mode Form and Instruction
Falls Diary Form and Instruction
Form 0920-17HO Final Survey Phone Mode Form and Instruction
Form 0920-17HO Final Survey Web Mode Form and Instruction
Form 0920-17HO Monthly Update Survey (months 1-11) Phone Mode Form and Instruction
Form 0920-17HO Monthly Update Survey (Months 1-11) Web Mode Form and Instruction
Form 0920-17HO Baseline Survey Phone Mode Form and Instruction
Form 0920-17HO Baseline Survey Web Mode Form and Instruction
Att A-1. PHSA Authorizing Legislation.doc Supplementary Document
Att A-2 AmeriSpeak Technical Overview 09 26 17.pdf Supplementary Document
Att A-9. IRB Protocol.doc Supplementary Document
Att A-8. AmeriSpeak Privacy Statement_Revised09 26 17.pdf Supplementary Document
Att A-6. Documentation for AmeriSpeak Panel for IRBs.pdf Supplementary Document
Att A-5. PIA Test Predictability of Falls Screening Tool TPFST 3-22-2017 (002).pdf Supplementary Document
Att A-7. AmeriSpeak Standard Profile Variables with Values.pdf Supplementary Document
Att A-10. IRB Approval.pdf Supplementary Document
Att A-11 Research Determination.pdf Supplementary Document
Att B-3. Falls Calendar & Log.docx Supplementary Document
Att B-4. Cover Letter for Monthly & Diary - Mail.docx Supplementary Document
Att B-5. Cover Letter for Monthly & Diary - Email.docx Supplementary Document
Att B-6. Proxy Survey Protocol.docx Supplementary Document
SSB_17HO_3.06.18.docx Supporting Statement B
SSA_17HO_3.06.18.docx Supporting Statement A
Proxy Survey Phone Mode Form and Instruction
Proxy Survey Web Mode Form and Instruction
Falls Diary Form and Instruction
Final Survey Phone Mode Form and Instruction
Final Survey Web Mode Form and Instruction
Monthly Update Survey (months 1-11) Phone Mode Form and Instruction
Monthly Update Survey (Months 1-11) Web Mode Form and Instruction
Baseline Survey Phone Mode Form and Instruction
Baseline Survey Web Mode Form and Instruction
Initial Postcard and Email Instruction

All Historical Document Collections

201709-0920-009

Approved with change

New collection (Request for a new OMB Control Number)

2017-10-27