[NCCDPHP] Evaluation of a Prostate Cancer Decision Aid

ICR 202505-0920-004

OMB: 0920-1438

Federal Form Document

Forms and Documents

Document Name	Status
Form 0920-24CB Pre-exposure Survey Form	Unchanged
Form 0920-24CB Patient Eligibility Screener Form	Unchanged
Form 0920-24CB Provider Survey Form	Unchanged
Form 0920-24CB Clinic Coordinator Interview Form	Unchanged
Form 0920-24CB Post-clinic Survey Form	Unchanged
Form 0920-24CB User Experience Interview Form	Unchanged
Form 0920-24CB Usability Survey Form	Unchanged
Form 0920-24CB Post-exposure survey Form	Unchanged
Change Request for CDC Prostate Cancer Screening Decision Aid Randomized Controlled Trial_2025April17.docx Justification for No Material/Nonsubstantive Change	2025-05-08
Attachment 13_Approved Privacy Narrative.pdf Supplementary Document	2024-08-05
4_Prostate Cancer_SSB.docx Supporting Statement B	2024-08-05
Attachment 14_Institutional Review Board Approval.docx Supplementary Document	2024-08-02
Attachment 03_Evaluation Questions and Indicators.docx Supplementary Document	2024-08-02
Attachment 02_Study Design Graphic.pdf Supplementary Document	2024-08-02
Attachment 01_Authorizing Legislation.pdf Supplementary Document	2024-08-02
_List of Attachments_SSA & SSB.docx Supplementary Document	2024-08-02
3_Prostate Cancer_SSA.docx Supporting Statement A	2024-08-02

IC Document Collections

IC ID	Document Title	Status
269819	Pre-exposure Survey Form	Unchanged
269818	Patient Eligibility Screener Form	Unchanged
269817	Provider Survey Form	Unchanged
269807	Clinic Coordinator Interview Form	Unchanged
269805	Post-clinic Survey Form	Unchanged
269803	User Experience Interview Form	Unchanged
269802	Usability Survey Form	Unchanged
269801	Post-exposure survey Form	Unchanged