Information Collection

Qualitative Assessment of Mothers' Attitudes ... National Birth Defects Prevention Study - Focus Group Moderator's Guide

IC 46391 under ICR 200612-0920-002 · OMB 0920-0737.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form None assigned Qualitative Assessment of Mothers' Attitudes ... National Birth Defects Prevention Study - Focus Group Moderator's Guide	Form and Instruction
None assigned Appendix I Moderators Guide_Participator rev 10-27-06 Appendix I Moderators Guide_Participator rev 10-27-06.doc	Form and Instruction
None assigned Appendix J Moderators Guide_Nonparticpator rev10-27-06 Appendix J Moderators Guide_Nonparticpator rev10-27-06.doc	Form and Instruction
Appendix B Battelle Phone Script rev 10-30-06.doc Appendix B Battelle Phone Script rev 10-30-06	IC Document
Appendix C Letter from Battelle rev 10-27-06.doc Appendix C Letter from Battelle rev 10-27-06	IC Document
Appendix D Scheduler Phone Script rev 10-30-06.doc Appendix D Scheduler Phone Script rev 10-30-06	IC Document
Appendix E Focus Group Letter 10-30-06.doc Appendix E Focus Group Letter 10-30-06	IC Document
Appendix G Reminder Script rev 10-30-06.doc Appendix G Reminder Script rev 10-30-06	IC Document
Appendix H Onsite Re-screen.doc Appendix H Onsite Re-screen	IC Document
Appendix F Focus Group Consent Form rev 10-27-06.doc Appendix F Focus Group Consent Form rev 10-27-06	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 42 CFR Part B.247b-4 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	None assigned	Appendix I Moderators Guide_Participator rev 10-27-06	Appendix I Moderators Guide_Participator rev 10-27-06.doc		Yes	Yes	Printable Only
Form and Instruction	None assigned	Appendix J Moderators Guide_Nonparticpator rev10-27-06	Appendix J Moderators Guide_Nonparticpator rev10-27-06.doc		Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 72

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	72	72
Annual IC Time Burden (Hours)	180	180
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix B Battelle Phone Script rev 10-30-06	Appendix B Battelle Phone Script rev 10-30-06.doc	11/20/2006
Appendix C Letter from Battelle rev 10-27-06	Appendix C Letter from Battelle rev 10-27-06.doc	11/20/2006
Appendix D Scheduler Phone Script rev 10-30-06	Appendix D Scheduler Phone Script rev 10-30-06.doc	11/20/2006
Appendix E Focus Group Letter 10-30-06	Appendix E Focus Group Letter 10-30-06.doc	11/20/2006
Appendix G Reminder Script rev 10-30-06	Appendix G Reminder Script rev 10-30-06.doc	11/20/2006
Appendix H Onsite Re-screen	Appendix H Onsite Re-screen.doc	11/20/2006
Appendix F Focus Group Consent Form rev 10-27-06	Appendix F Focus Group Consent Form rev 10-27-06.doc	11/20/2006

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