Information Collection

Focus Groups with Family Caregivers

IC 204406 under ICR 201103-0925-005 · OMB 0925-0634.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Focus Group Questionnaires (Guide) Focus Groups with Family Caregivers	Form and Instruction
Form 1 Pre-Focus Group Form Focus Groups with Family Caregivers	Form and Instruction
1 Focus Group Questionnaires (Guide) 0925-0634 NIA Focus Group Question Guide--family caregiver rev 9.27.2012.doc	Form and Instruction
1 Pre-Focus Group Form 0925-0634 NIA pre-focus group questionnaire--family caregivers rev 9.27.2012.doc	Form and Instruction
0925-0634 family caregiver focus group generic_clearance_form doc rev 9.27.2012.doc 0925-0634 family caregiver focus group generic_clearance_form doc rev 9	IC Document
0925-0634 NIA mini supporting statement A--family caregiver project 10 2 2102.doc 0925-0634 NIA mini supporting statement A--family caregiver project 10 2 2102	IC Document
0925-0634 NIA mini supporting statement B--family caregivers project 9.27.2012.doc 0925-0634 NIA mini supporting statement B--family caregivers project 9	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				No	No	Printable Only
Form and Instruction	1				No	No	Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 60

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	60	0	0	0	0	0
Annual IC Time Burden (Hours)	70	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
0925-0634 family caregiver focus group generic_clearance_form doc rev 9		10/05/2012
0925-0634 NIA mini supporting statement A--family caregiver project 10 2 2102		10/05/2012
0925-0634 NIA mini supporting statement B--family caregivers project 9		10/05/2012

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

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