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Phase I Focus Group Questions Moderator Guide
Field Evaluation of Prototype Kneel-Assist Devices in Low-Seam Mining
OMB: 0920-0843
IC ID: 191371
OMB.report
HHS/CDC
OMB 0920-0843
ICR 200911-0920-006
IC 191371
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0843 can be found here:
2012-12-07 - Extension without change of a currently approved collection
2010-01-29 - New collection (Request for a new OMB Control Number)
Documents and Forms
Document Name
Document Type
Form 1
Phase I Focus Group Questions Moderator Guide
Form and Instruction
1 Phase I Section Foreman Form
Attachment 6 - Phase I Section Foreman Form.doc
Form and Instruction
2 Phase I Baseline Form
Attachment 7 - Phase I Baseline Form.doc
Form
3 Phase I 1 month form
Attachment 8 - Phase I 1 month form.doc
Form
4 Phase I Focus Group Questions Moderator Guide
Attachment 9 - Phase I Focus Group Questions.doc
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Phase I Focus Group Questions Moderator Guide
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
1
Phase I Section Foreman Form
Attachment 6 - Phase I Section Foreman Form.doc
No
No
Paper Only
Form
2
Phase I Baseline Form
Attachment 7 - Phase I Baseline Form.doc
No
No
Paper Only
Form
3
Phase I 1 month form
Attachment 8 - Phase I 1 month form.doc
No
No
Paper Only
Form and Instruction
4
Phase I Focus Group Questions Moderator Guide
Attachment 9 - Phase I Focus Group Questions.doc
No
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
9
Number of Respondents for Small Entity:
1
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
0 %
Requested
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
9
0
9
0
0
0
Annual IC Time Burden (Hours)
9
0
9
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
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.