Information Collection

Caregivers - Focus Group

IC 181189 under ICR 200707-0920-003 · OMB 0920-0759.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Focus Group Moderators Guide Caregivers - Focus Group	Form and Instruction
Focus Group Moderators Guide Attachment C1-Focus Group Moderators Guide.doc	Form and Instruction
Att C6 and C8--Focus Group Confirmation and Consent.doc Focus Group Consent and Confirmation Letters	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

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	Focus Group Moderators Guide	Attachment C1-Focus Group Moderators Guide.doc		No	No	Paper Only

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 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	80	80
Annual IC Time Burden (Hours)	160	160
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Focus Group Consent and Confirmation Letters	Att C6 and C8--Focus Group Confirmation and Consent.doc	06/17/2007

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