#4.Program Participant Focus Group and Interview Protocol

Evaluation of Tribal Health Profession Opportunity Grants

Documents and Forms

Document Name Document Type
#4.Program Participant Focus Group and Interview Protocol_Revised per OMB questions.doc Other-#4

Information Collection (IC) Details

IC Title:	#4.Program Participant Focus Group and Interview Protocol	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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-#4			#4.Program Participant Focus Group and Interview Protocol_Revised per OMB questions.doc		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 117	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	117	0	117
Annual IC Time Burden (Hours)	158	0	158
Annual IC Cost Burden (Dollars)	0	-1,165	1,165

Documents for IC

Title	Document	Date Uploaded
No associated records found

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