Information Collection Request

AHRQ Healthcare Innovations Exchange Innovator Interview and AHRQ Healthcare Innovations Exchange Innovator Email Submission Guidelines

ICR 201102-0935-004 · OMB 0935-0147 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form Form #3 Annual follow-up reviews Form and Instruction New Repair queued
Form Form #2 Health care innovator interview Form and Instruction New Available
Form Form #4 Annual follow-up interview Form and Instruction Removed Available
Form Form #3 Health care innovator interview - without email submission Form and Instruction Removed Available
Form Form #2 Health care innovator interview -following email submission Form and Instruction Removed Available
Form Form #1 Email submission Form and Instruction Modified Available
Attachment G -- Expert Consultation 0818_10.doc Supplementary Document Uploaded 2011-01-25 Available
Attachment F -- Federal Register Notice.pdf Supplementary Document Uploaded 2011-01-25 Available
Attachment E -- Websites that Offer Healthcare Quality Improvement and Innovation Information 0818_10.doc Supplementary Document Uploaded 2011-01-25 Available
Attachment A -- Healthcare Research and Quality Act of 1999.pdf Supplementary Document Uploaded 2011-01-25 Available
Supporting Statement Part A -- AHRQ Healthcare Innovations Exchange 5-23-2011.docx Supporting Statement A Uploaded 2011-05-23 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
196422 Annual follow-up reviews Form and Instruction New
196421 Health care innovator interview Form and Instruction New
187246 Annual follow-up interview Form and Instruction Removed
187245 Health care innovator interview - without email submission Form and Instruction Removed
187244 Health care innovator interview -following email submission Form and Instruction Removed
187243 Email submission Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
05/31/2014 36 Months From Approved 05/31/2011
909 0 566
581 0 401
0 0 0





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 909 566 0 343 0 0
Annual Time Burden (Hours) 581 401 0 180 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No