Focus Groups

Program Evaluation of the Ninth Scope of Work Quality Improvement Organization Program (CMS-10294)

Documents and Forms

Document Name Document Type
Form CMS-10294 Focus Groups Form and Instruction
CMS-10294 CMS-10294.QIO Surveys and Letters CMS-10294.QIO Surveys and Letters.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	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	CMS-10294	CMS-10294.QIO Surveys and Letters	CMS-10294.QIO Surveys and Letters.pdf		No	No	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 40	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	40	40
Annual IC Time Burden (Hours)	60	60
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.