Information Collection

NCCAM Information Products In-Person Focus Groups

IC 204196 under ICR 201012-0925-002 · OMB 0925-0530.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 NCCAM Information Products In-Person Focus Groups	Form and Instruction
1 NCCAM Focus Group Discussion Guiide NCCAM Focus Group Discussion Guide 7-2-12 rev.doc	Form and Instruction
Formative Research Clearance Form Final 7-11-12 rev.doc Generic Request Form	IC Document
Formative Research Cover Memo Updated 7-11-2012.rev.doc Project Cover Memo	IC Document
Flu Colds Posted on Web 6-11-12.pdf Proposed Web Version	IC Document
Flu_Colds_for_Formative_Research_NCCAM_6-11-12.pdf Focus Group Version	IC Document
Spinal Manipulation for LBP Posted on Web 6-11-12.pdf Proposed Web Version	IC Document
Spinal_Manip_for_Formative_Research_NCCAM_6-11-12.pdf Focus Group Version	IC Document

IC Title:

Agency IC Tracking Number:

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	1	NCCAM Focus Group Discussion Guiide	NCCAM Focus Group Discussion Guide 7-2-12 rev.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 30

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	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	30	0	0	0	0	0
Annual IC Time Burden (Hours)	60	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Generic Request Form	Formative Research Clearance Form Final 7-11-12 rev.doc	09/21/2012
Project Cover Memo	Formative Research Cover Memo Updated 7-11-2012.rev.doc	09/21/2012
Proposed Web Version	Flu Colds Posted on Web 6-11-12.pdf	09/21/2012
Focus Group Version	Flu_Colds_for_Formative_Research_NCCAM_6-11-12.pdf	09/21/2012
Proposed Web Version	Spinal Manipulation for LBP Posted on Web 6-11-12.pdf	09/21/2012
Focus Group Version	Spinal_Manip_for_Formative_Research_NCCAM_6-11-12.pdf	09/21/2012

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