Information Collection

Consumer/Patient Focus Groups

IC 200339 under ICR 201112-0935-001 · OMB 0935-0191.

Documents and Forms

Document Name Document Type
Form Form #6 Consumer/Patient Focus Groups Form and Instruction
Form #6 Consumer or Patient Focus Group Guide -- Aware with use Attachment H -- Consumer or Patient Focus Group Guide -- Aware With Use.doc Form and Instruction
Form #7 Consumer or Patient Focus Group Guide -- Aware without u Attachment I -- Consumer or Patient Focus Group Guide -- Aware without Use.doc Form and Instruction
Form #8 Consumer or Patient Focus Group Guide -- Unaware of CER Attachment J -- Consumer or Patient Focus Group Guide -- Unaware of CER.doc Form and Instruction
Attachment L -- Consumer or Patient Focus Group Respondent Materials.doc Attachment L -- Consumer or Patient Focus Group Respondent Materials IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Consumer/Patient 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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Form #6	Consumer or Patient Focus Group Guide -- Aware with use	Attachment H -- Consumer or Patient Focus Group Guide -- Aware With Use.doc	Yes	Yes	Printable Only
Form and Instruction	Form #7	Consumer or Patient Focus Group Guide -- Aware without use	Attachment I -- Consumer or Patient Focus Group Guide -- Aware without Use.doc	Yes	Yes	Paper Only
Form and Instruction	Form #8	Consumer or Patient Focus Group Guide -- Unaware of CER	Attachment J -- Consumer or Patient Focus Group Guide -- Unaware of CER.doc	Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 96	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	96	96
Annual IC Time Burden (Hours)	144	144
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment L -- Consumer or Patient Focus Group Respondent Materials	Attachment L -- Consumer or Patient 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.