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Deliberative Experience Survey
Use of Deliberative Methods to Enhance Public Engagement in Comparative Effectiveness Research
OMB: 0935-0199
IC ID: 201436
OMB.report
HHS/AHRQ
OMB 0935-0199
ICR 201203-0935-001
IC 201436
( )
Documents and Forms
Document Name
Document Type
Form Form #10
Deliberative Experience Survey
Form and Instruction
Form #10 Deliberative Experience Survey
Attachment F - Deliberative Experience Survey.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Deliberative Experience Survey
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 #10
Deliberative Experience Survey
Attachment F - Deliberative Experience Survey.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Immunization Management
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
960
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
960
0
960
0
0
0
Annual IC Time Burden (Hours)
240
0
240
0
0
0
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.