Information Collection

Communications Testing for Comprehensive Communication Campaign for HITECH Act - Consumer Survey Focus Group

IC 207629 under ICR 201208-0955-005 · OMB 0955-0005.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0955-0005 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
ATTACHMENT C Moderator Guide Consumer FGs 6 2013 FINAL.DOCX	Instruction
ATTACHMENT A ConsumerSurveyQuestionnaire FINAL.docx	Other-Consumer Survey
ATTACHMENT B Screeners for ONC consumer groups FINAL.DOCX	Other-Screeners
ATTACHMENT D ONC_ConsumerPSAStoryboard8 4A_Balloon.pdf	Instruction
ATTACHMENT E ONC_ConsumerPSAStoryboard8 4A_Files.pdf	Instruction
ATTACHMENT F ONC_ConsumerPSAStoryboard8 4A_Testimonial.pdf	Instruction
BB Hub Mockups.pdf	Other-BB Hub Mockup
IC HITECH Consumer Survey and FG Statement (3).docx HITECH Consumer Survey	IC Document

IC Title:

Communications Testing for Comprehensive Communication Campaign for HITECH Act - Consumer Survey Focus Group

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction	ATTACHMENT C Moderator Guide Consumer FGs 6 2013 FINAL.DOCX	No	No	Fillable Fileable
Other-Consumer Survey	ATTACHMENT A ConsumerSurveyQuestionnaire FINAL.docx	No	No	Fillable Fileable
Other-Screeners	ATTACHMENT B Screeners for ONC consumer groups FINAL.DOCX	No	No	Fillable Fileable
Instruction	ATTACHMENT D ONC_ConsumerPSAStoryboard8 4A_Balloon.pdf	No	No	Fillable Fileable
Instruction	ATTACHMENT E ONC_ConsumerPSAStoryboard8 4A_Files.pdf	No	No	Fillable Fileable
Instruction	ATTACHMENT F ONC_ConsumerPSAStoryboard8 4A_Testimonial.pdf	No	No	Fillable Fileable
Other-BB Hub Mockup	BB Hub Mockups.pdf	No	No	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10,270

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

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	10,270	0	0	0	0	0
Annual IC Time Burden (Hours)	1,166	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
HITECH Consumer Survey	IC HITECH Consumer Survey and FG Statement (3).docx	07/02/2013

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