OMB
.report
Search
Consumer/Patient Focus Groups
Evaluation of ARRA Comparative Effectiveness Research Dissemination Contractor Efforts
OMB: 0935-0191
IC ID: 200339
OMB.report
HHS/AHRQ
OMB 0935-0191
ICR 201112-0935-001
IC 200339
( )
Documents and Forms
Document Name
Document Type
Form Form #6
Consumer/Patient Focus Groups
Form and Instruction
Form #6 Consumer or Patient Focus Group Guide -- Aware with use
Attachment H -- Consumer or Patient Focus Group Guide -- Aware With Use.doc
Form and Instruction
Form #7 Consumer or Patient Focus Group Guide -- Aware without u
Attachment I -- Consumer or Patient Focus Group Guide -- Aware without Use.doc
Form and Instruction
Form #8 Consumer or Patient Focus Group Guide -- Unaware of CER
Attachment J -- Consumer or Patient Focus Group Guide -- Unaware of CER.doc
Form and Instruction
Attachment L -- Consumer or Patient Focus Group Respondent Materials.doc
Attachment L -- Consumer or Patient Focus Group Respondent Materials
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Consumer/Patient Focus Groups
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
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
Form #6
Consumer or Patient Focus Group Guide -- Aware with use
Attachment H -- Consumer or Patient Focus Group Guide -- Aware With Use.doc
Yes
Yes
Printable Only
Form and Instruction
Form #7
Consumer or Patient Focus Group Guide -- Aware without use
Attachment I -- Consumer or Patient Focus Group Guide -- Aware without Use.doc
Yes
Yes
Paper Only
Form and Instruction
Form #8
Consumer or Patient Focus Group Guide -- Unaware of CER
Attachment J -- Consumer or Patient Focus Group Guide -- Unaware of CER.doc
Yes
Yes
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Immunization Management
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
96
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
96
0
96
0
0
0
Annual IC Time Burden (Hours)
144
0
144
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Attachment L -- Consumer or Patient Focus Group Respondent Materials
Attachment L -- Consumer or Patient Focus Group Respondent Materials.doc
11/30/2011
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.