Information Collection

Focus Group Discussion Guide

IC 202905 under ICR 201206-0920-007 · OMB 0920-0947.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment_3B_Focus_Group_Discussion_Guide[1].docx	Other-Discussion Guide
Attachment 3B Focus Group Discussion Guide.docx Attachment 3B Focus Group Discussion Guide	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

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
Other-Discussion Guide			Attachment_3B_Focus_Group_Discussion_Guide[1].docx		No		Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 72

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 Agency Discretion
Annual Number of Responses for this IC	72	72
Annual IC Time Burden (Hours)	108	108
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment 3B Focus Group Discussion Guide	Attachment 3B Focus Group Discussion Guide.docx	09/07/2012

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