NEI Health Focus Groups with New Audiences Ages 25-35

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NIH)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Document Name Document Type
Form 1 NEI Health Focus Groups with New Audiences Ages 25-35 Form and Instruction
1 NEI Screener Attachment A-NEI-OMB-Screener_New_Aud_FG_2018-03-07.docx Form and Instruction
2 NEI Mod Guide Attachment B-NEI-OMB-Mod_Guide_New_Aud_FG_2018-03-07.docx Form and Instruction
Generic_Clearance_Request_NEI_OMB_New_Aud_FG_Rev_2018-03-07.doc NEI Health Focus Group with New Audiences Ages 25-35 IC Document

Information Collection (IC) Details

IC Title:	NEI Health Focus Groups with New Audiences Ages 25-35	Agency IC Tracking Number:

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	1	NEI Screener	Attachment A-NEI-OMB-Screener_New_Aud_FG_2018-03-07.docx		No		Paper Only
Form and Instruction	2	NEI Mod Guide	Attachment B-NEI-OMB-Mod_Guide_New_Aud_FG_2018-03-07.docx		No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 288	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	288	288
Annual IC Time Burden (Hours)	173	173
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
NEI Health Focus Group with New Audiences Ages 25-35	Generic_Clearance_Request_NEI_OMB_New_Aud_FG_Rev_2018-03-07.doc	03/07/2018

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.