Information Collection

Adolescent Focus Groups

IC 209254 under ICR 201311-0935-001 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Form #8 Adolescent Focus Groups	Form and Instruction
Form #8 Adolescent Focus Group Protocol Attachment K- Adolescent Focus Group Protocol.docx	Form and Instruction
Attachment L- Adolescent Focus Group Recruitment Materials.docx Attachment L- Adolescent Focus Group Recruitment Materials	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
Form and Instruction	Form #8	Adolescent Focus Group Protocol	Attachment K- Adolescent Focus Group Protocol.docx		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 40

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	40	40
Annual IC Time Burden (Hours)	60	60
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment L- Adolescent Focus Group Recruitment Materials	Attachment L- Adolescent Focus Group Recruitment Materials.docx	11/06/2013

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