Physician Focus Group

Formative Research on Lung Cancer Screening

Documents and Forms

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

Information Collection (IC) Details

IC Title:	Physician Focus Group	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
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 %

	Approved	Previously Approved
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

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.