Consumer Focus Groups

Evaluation of the Text4baby Program

Documents and Forms

Document Name Document Type
Form Focus Group-2 Consumer Focus Groups Form
Focus Group-2 Focus Group: Participant Information Form (Pregnant Wome Part A Attachment D2 Participant Information Form Pregnant Women-FINAL.docx Form
Focus Group-3 Focus Group: Participant Information Form (Postpartum Wo Part A Attachment D3 Participant Information Form Postpartum Women - FINAL.docx Form
Focus Group-1 Focus Group Discussion Protocol Attachment D1 Consumer Focus Group Protocol May 2012.docx Form

Information Collection (IC) Details

IC Title:	Consumer Focus Groups	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	Focus Group-2	Focus Group: Participant Information Form (Pregnant Women)	Part A Attachment D2 Participant Information Form Pregnant Women-FINAL.docx	No	No	Paper Only
Form	Focus Group-3	Focus Group: Participant Information Form (Postpartum Women)	Part A Attachment D3 Participant Information Form Postpartum Women - FINAL.docx	No	No	Paper Only
Form	Focus Group-1	Focus Group Discussion Protocol	Attachment D1 Consumer Focus Group Protocol May 2012.docx	No	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 80	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	80	80
Annual IC Time Burden (Hours)	120	120
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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