Information Collection

Focus Groups

IC 188364 under ICR 200903-0935-002 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Form #3 Focus Groups	Form and Instruction
Form #2 Emergency Department Focus Group Guide Attachment C -- Emergency Department Focus Group Guide.doc	Form and Instruction
Form #3 Call Center Focus Group Guide Attachment D -- Call Center Focus Group Guide.doc	Form and Instruction

IC Title:

Focus Groups

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
Form and Instruction	Form #3	Call Center Focus Group Guide	Attachment D -- Call Center Focus Group Guide.doc		Yes	Yes	Paper Only
Form and Instruction	Form #2	Emergency Department Focus Group Guide	Attachment C -- Emergency Department Focus Group Guide.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 4

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	32	32
Annual IC Time Burden (Hours)	32	32
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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