Information Collection Request

AHRQ Healthcare Innovations Exchange Innovator Interview and AHRQ Healthcare Innovations Exchange Innovator Email Submission Guidelines

ICR 200811-0935-001 · OMB 0935-0147 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form Form #4 Annual follow-up interview Form and Instruction New Available
Form Form #3 Health care innovator interview - without email submission Form and Instruction New Available
Form Form #2 Health care innovator interview -following email submission Form and Instruction New Available
Form Form #1 Email submission Form New Available
List_Inclusion_Exclusion_Criteria_Final.doc Supplementary Document Uploaded 2009-03-12 Available
OMB passbacks.doc Supplementary Document Uploaded 2009-03-12 Available
Response to OMB Questions of January 12 09_NIX.doc Supplementary Document Uploaded 2009-03-12 Available
Attachment G -- Expert Consultation.doc Supplementary Document Uploaded 2008-11-03 Available
Attachment F -- 60 Day FRN -- AHRQ Healthcare Innovations Exchange Interview & Submission Guidlines.pdf Supplementary Document Uploaded 2008-11-03 Available
Attachment E -- List of Websites.doc Supplementary Document Uploaded 2008-11-03 Available
Supporting Statement -- Innovations Exchange 11-3-2008.doc Supporting Statement A Uploaded 2008-11-03 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
187246 Annual follow-up interview Form and Instruction New
187245 Health care innovator interview - without email submission Form and Instruction New
187244 Health care innovator interview -following email submission Form and Instruction New
187243 Email submission Form New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
03/31/2011 36 Months From Approved
566 0 0
401 0 0
0 0 0





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 566 0 0 566 0 0
Annual Time Burden (Hours) 401 0 0 401 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No