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Federal forms, ICRs, and supporting documents

Information Collection

Conducting Focus Groups & In Depth Interviews to Understand and Differentiate the Impact of REMS/ETASU on Prescriber Practices

IC 204195 under ICR 201404-0910-001 · OMB 0910-0497.

Documents and Forms
Document Name
Document Type
Other-Moderator Guide
Other-Participant Informed Consent F
Other-Screener
Other-Interviewee Email Invitations
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Conducting Focus Groups & In Depth Interviews to Understand and Differentiate the Impact of REMS/ETASU on Prescriber Practices
 
Unchanged
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Moderator Guide Task1_REMS_Moderator Guide_v4_9c10e16b.docx Yes No Fillable Printable
Other-Participant Informed Consent Form Task1-REMS_Participant-Informed-Consent_v3_031312.doc Yes No Fillable Printable
Other-Screener Task1-REMS_Screener_for_FocusGroups_Deloitte_v5_Q6.docx Yes No Fillable Printable
Other-Interviewee Email Invitations Task1-REMS_Interviewee_EmailInvitations_v5_031312.docx No No Fillable Printable

Health Illness Prevention

 

108 0
   
Individuals or Households
 
   0 %

  Requested 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 108 0 0 0 0 108
Annual IC Time Burden (Hours) 216 0 0 0 0 216
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
OMB Clearance Memo FDAFocusGroupGenICMemoREMS ETASU 11-8-12.doc 11/09/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.