Valuing Reduced Asthma Episodes For Adults And Children -- Focus Groups

Valuing Reduced Asthma Episodes for Adults and Children - Focus Groups

Documents and Forms

Document Name Document Type
Adult version Asthma survey.doc Other-Focus Group Survey Instrument
Child version Asthma survey.doc Other-Focus Group Survey Instrument
Focus Group Topics.doc Instruction

Information Collection (IC) Details

IC Title:	Valuing Reduced Asthma Episodes For Adults And Children -- Focus Groups	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Focus Group Survey Instrument	Adult version Asthma survey.doc	Yes	Yes	Fillable Printable
Other-Focus Group Survey Instrument 2	Child version Asthma survey.doc	Yes	Yes	Fillable Printable
Instruction	Focus Group Topics.doc	No	No	Paper Only

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	100	100
Annual IC Cost Burden (Dollars)	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.