Information Collection

Focus Groups Involving Children Moderator's Guide

IC 184640 under ICR 200804-0920-005 · OMB 0920-0795.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix F Mod Guide for Children.doc	Other-Children's/Youth Focus Groups
Appendix E2 Parental Permission.doc Parental Permission Form	IC Document
Appendix E3 Youth Assent.doc Youth Assent Form	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
Other-Children's/Youth Focus Groups Discussion Outline			Appendix F Mod Guide for Children.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 384

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	384	384
Annual IC Time Burden (Hours)	768	768
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Parental Permission Form	Appendix E2 Parental Permission.doc	03/31/2008
Youth Assent Form	Appendix E3 Youth Assent.doc	03/31/2008

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