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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.