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Clinician Focus Groups
Evaluation of ARRA Comparative Effectiveness Research Dissemination Contractor Efforts
OMB: 0935-0191
IC ID: 200337
OMB.report
HHS/AHRQ
OMB 0935-0191
ICR 201112-0935-001
IC 200337
( )
Documents and Forms
Document Name
Document Type
Form Form #4
Clinician Focus Groups
Form and Instruction
Form #4 Clinician Focus Group Guide
Attachment F -- Clinician Focus Group Guide.doc
Form and Instruction
Attachment G -- Clinician Focus Group Respondent Materials.doc
Attachment G -- Clinician Focus Group Respondent Materials
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Clinician Focus Groups
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 #4
Clinician Focus Group Guide
Attachment F -- Clinician Focus Group Guide.doc
Yes
Yes
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Immunization Management
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
72
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 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
72
0
72
0
0
0
Annual IC Time Burden (Hours)
72
0
72
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Attachment G -- Clinician Focus Group Respondent Materials
Attachment G -- Clinician Focus Group Respondent Materials.doc
11/30/2011
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.