Information Collection

Semi-structured interview

IC 193966 under ICR 201007-0935-003 · OMB 0935-0170.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0935-0170 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Form #1 Semi-structured interview	Form and Instruction
Form #1 Semi-structured interview guide ATTACHMENT E -- Semi-structured interview guide.docx	Form and Instruction
ATTACHMENT F -- AHRQ NITS Informed Consent Form.docx ATTACHMENT F -- AHRQ NITS Informed Consent Form	IC Document

IC Title:

Semi-structured interview

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 and Instruction	Form #1	Semi-structured interview guide	ATTACHMENT E -- Semi-structured interview guide.docx		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 9

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	81	81
Annual IC Time Burden (Hours)	81	81
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
ATTACHMENT F -- AHRQ NITS Informed Consent Form	ATTACHMENT F -- AHRQ NITS Informed Consent Form.docx	07/09/2010

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