Focus Group with Consumers

Evaluation of Childhood Obesity Prevention and Control Initiative: New York City Healthy Bucks Program

Documents and Forms

Document Name Document Type
Focus Group with Consumers Form
Focus Group Guide for Farmers Market Consumers Appendix H-1 Consumer FG Guide_01.21.10.doc Form
Appendix H-2 Consumer FG Consent Form_01.21.10.doc Focus Group Consent for Farmers Market Consumers IC Document

Information Collection (IC) Details

IC Title:	Focus Group with Consumers	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	none	Focus Group Guide for Farmers Market Consumers	Appendix H-1 Consumer FG Guide_01.21.10.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 48	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	48	48
Annual IC Time Burden (Hours)	96	96
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Focus Group Consent for Farmers Market Consumers	Appendix H-2 Consumer FG Consent Form_01.21.10.doc	04/01/2010

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