Information Collection

Caregivers - Focus Group

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

Documents and Forms

Document Name Document Type
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

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Caregivers - Focus Group	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	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 %

	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

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.