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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.