Information Collection

Upper Limb Prosthetic User Needs and Preferences Study: Focus Group Protocol

IC 221775 under ICR 201406-0910-019 · OMB 0910-0497.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0497 can be found here:

Documents and Forms

Document Name Document Type
Informed Consent.doc Other-Consent Form
Participant Recruitment Notice.docx Other-Participant Recruitment Notice
Memo--Upper Limb Prosthetic User Needs and Preferences Study.doc Memo--Upper Limb Prosthetic User Needs and Preferences Study IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Upper Limb Prosthetic User Needs and Preferences Study: Focus Group Protocol	Agency IC Tracking Number:	CDRH

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Consent Form			Informed Consent.doc		No		Paper Only
Other-Participant Recruitment Notice			Participant Recruitment Notice.docx		No		Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 24	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	24	24
Annual IC Time Burden (Hours)	72	72
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Memo--Upper Limb Prosthetic User Needs and Preferences Study	Memo--Upper Limb Prosthetic User Needs and Preferences Study.doc	06/02/2016

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