Information Collection

Semi-structured Interview with Primary care physicians

IC 189144 under ICR 200905-0935-002 · OMB 0935-0154.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Form #6 Semi-structured Interview with Primary care physicians	Form
Form #6 Semi-structured Interview with Primary care physicians Attachment F -- Semi-structured interview with primary care physicians.doc	Form
Attachment F1 -- Physician and Pharmacist Recruit letter.doc Attachment F1 -- Physician and Pharmacist Recruit letter	IC Document

IC Title:

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	Form #6	Semi-structured Interview with Primary care physicians	Attachment F -- Semi-structured interview with primary care physicians.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 20

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
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	20	20
Annual IC Time Burden (Hours)	7	7
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment F1 -- Physician and Pharmacist Recruit letter	Attachment F1 -- Physician and Pharmacist Recruit letter.doc	05/11/2009

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