Information Collection

Physician Focus Group

IC 187254 under ICR 200811-0920-003 · OMB 0920-0801.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0801 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment G Moderator Guide Physician FG.doc	Other-WORD
Attachment G1 Provider Recruitment Materials.doc Attachment G1 Provider Recruitment Materials	IC Document
Attachment G2 Physician Informed Consent.doc Attachment G2 Physician Informed Consent	IC Document

IC Title:

Physician Focus Group

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-WORD			Attachment G Moderator Guide Physician FG.doc		No	No	Fillable Printable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 24

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	24	24
Annual IC Time Burden (Hours)	30	30
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment G1 Provider Recruitment Materials	Attachment G1 Provider Recruitment Materials.doc	11/05/2008
Attachment G2 Physician Informed Consent	Attachment G2 Physician Informed Consent.doc	11/05/2008

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