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Consumer Focus Groups
Evaluation of the Text4baby Program
OMB: 0915-0347
IC ID: 200140
OMB.report
HHS/HSA
OMB 0915-0347
ICR 201207-0915-001
IC 200140
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0347 can be found here:
2012-08-17 - No material or nonsubstantive change to a currently approved collection
2012-07-10 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form Focus Group-2
Consumer Focus Groups
Form
Focus Group-2 Focus Group: Participant Information Form (Pregnant Wome
Part A Attachment D2 Participant Information Form Pregnant Women-FINAL.docx
Form
Focus Group-3 Focus Group: Participant Information Form (Postpartum Wo
Part A Attachment D3 Participant Information Form Postpartum Women - FINAL.docx
Form
Focus Group-1 Focus Group Protocol
Attachment D1 Consumer Focus Group Protocol May 2012.docx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Consumer Focus Groups
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
Focus Group-2
Focus Group: Participant Information Form (Pregnant Women)
Part A Attachment D2 Participant Information Form Pregnant Women-FINAL.docx
No
No
Paper Only
Form
Focus Group-3
Focus Group: Participant Information Form (Postpartum Women)
Part A Attachment D3 Participant Information Form Postpartum Women - FINAL.docx
No
No
Paper Only
Form
Focus Group-1
Focus Group Protocol
Attachment D1 Consumer Focus Group Protocol May 2012.docx
No
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
80
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Requested
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
80
0
0
0
0
80
Annual IC Time Burden (Hours)
120
0
0
0
0
120
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.