OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Patients at Primary Care Pactices (Patient Focus Groups)

IC 193000 under ICR 201208-0955-011 · OMB 0955-0011.

Documents and Forms
Document Name
Document Type
Other-Script
Other-guide
Other-recruitment
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Patients at Primary Care Pactices (Patient Focus Groups)
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Script 0990-PatientPerspective_App H2 Patient Recruitment Script Spanish.doc No No Paper Only
Other-guide 0990-PatientPerspective_App K Focus Group Moderator's Guide.doc No No Paper Only
Other-recruitment 0990-PatientPerspective_App H1 Patient Recruitment Script.doc No No Paper Only

Health Public Health Monitoring

 

20 0
   
Individuals or Households
 
   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 20 0 0 0 0 20
Annual IC Time Burden (Hours) 30 0 0 0 0 30
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
0990-PatientPerspective_App J2 Focus Group Postcard 0990-PatientPerspective_App J2 Focus Group Postcard.doc 05/04/2010
0990-PatientPerspective_App J1 Patient Focus Group Fact Sheet 0990-PatientPerspective_App J1 Patient Focus Group Fact Sheet.doc 05/04/2010
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.