Information Collection

Bright Futures for Women's Health and Wellness - Focus Groups

IC 190118 under ICR 200907-0915-003 · OMB 0915-0329.

Documents and Forms

Document Name Document Type
Form 003_BFWHWEmWell_fo Bright Futures for Women's Health and Wellness - Focus Groups Form and Instruction
003_BFWHWEmWell_fo 003_BFWHWEmWell_focus BFWHW Focus Group Tool.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Bright Futures for Women's Health and Wellness - Focus Groups	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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
Form and Instruction	003_BFWHWEmWell_focus	003_BFWHWEmWell_focus	BFWHW Focus Group Tool.pdf		Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 64	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	64	64
Annual IC Time Burden (Hours)	96	96
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.