Family/Caregiver Focus Group Discussion

Pediatric Mental Health Care Access Program National Impact Study

Documents and Forms

Document Name Document Type
Form 2 Family/Caregiver Focus Group Discussion Form and Instruction
2 Family-Caregiver Focus Group Discussion Attachment B2 - Family-Caregiver FGD_Final.docx Form and Instruction
2 Family-Caregiver Focus Group Discussion Attachment B2 - Family-Caregiver FGD_Final.docx Form and Instruction
Attachment B5 - Family-Caregiver FGD Consent_Final.docx Attachment B5 - Family-Caregiver FGD Consent_Final IC Document
Attachment B5 - Family-Caregiver FGD Consent_Final.docx Attachment B5 - Family-Caregiver FGD Consent_Final IC Document

Information Collection (IC) Details

IC Title:	Family/Caregiver Focus Group Discussion	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	2	Family-Caregiver Focus Group Discussion	Attachment B2 - Family-Caregiver FGD_Final.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 42	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	42	42
Annual IC Time Burden (Hours)	42	42
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment B5 - Family-Caregiver FGD Consent_Final	Attachment B5 - Family-Caregiver FGD Consent_Final.docx	04/30/2024

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