BCRS NELRP and NSP Focus Groups

Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0212 can be found here:

Documents and Forms

Document Name Document Type
Form 1 BCRS NELRP and NSP Focus Groups Form and Instruction
1 IDI Moderator Guide Nurses Administrators et al Creative IDI Moderator Guide Nurses Administrators et al Creative Exploratory.docx Form and Instruction
2 In Person Moderator Guide Nurses Prospects Creative Expl In Person Moderator Guide Nurses Prospects Creative Exploratory.docx Form and Instruction
3 Online Focus Group Guide Nursing Current Participants Online Focus Group Guide Nursing Current Participants.docx Form and Instruction
4 Online Focus Group Guide Nursing Prospective Applicants Online Focus Group Guide Nursing Prospective Applicants.docx Form and Instruction
Supporting Statement A.docx Supporting Statement IC Document

Information Collection (IC) Details

IC Title:	BCRS NELRP and NSP Focus Groups	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	IDI Moderator Guide Nurses Administrators et al Creative Exploratory	IDI Moderator Guide Nurses Administrators et al Creative Exploratory.docx	Yes	No	Paper Only
Form and Instruction	2	In Person Moderator Guide Nurses Prospects Creative Exploratory	In Person Moderator Guide Nurses Prospects Creative Exploratory.docx	Yes	No	Paper Only
Form and Instruction	3	Online Focus Group Guide Nursing Current Participants	Online Focus Group Guide Nursing Current Participants.docx	Yes	No	Paper Only
Form and Instruction	4	Online Focus Group Guide Nursing Prospective Applicants	Online Focus Group Guide Nursing Prospective Applicants.docx	Yes	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 104	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 57 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	104	0	0	0	0	0
Annual IC Time Burden (Hours)	186	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement	Supporting Statement A.docx	03/12/2012

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