MONAHRQ Program Evaluation End User Focus Groups Protocol

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0935-0179 can be found here:

Documents and Forms

Document Name Document Type
OMB - Consumer End Users FG protocol draft.docx Instruction
2 MONAHRQ Professional End Users Focus Group protocol OMB - Professional End Users FG protocol draft.docx Form and Instruction
OMB Cover Letter.doc Cover Letter IC Document
OMB - expedited Submission Form_MONAHRQ program evaluation_revised 03-26-15.docx Supporting Statement Part A IC Document
OMB - Part B ICR supporting statement MONAHRQ 1 14 15.docx Supporting Statement Part B IC Document
OMB - Consumer End Users FG protocol draft.docx • MONAHRQ Consumer End Users Focus Group protocol IC Document
OMB - Professional End Users FG protocol draft.docx • MONAHRQ Professional End Users Focus Group protocol IC Document

Information Collection (IC) Details

IC Title:	MONAHRQ Program Evaluation End User Focus Groups Protocol	Agency IC Tracking Number:

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
Instruction			OMB - Consumer End Users FG protocol draft.docx		Yes	Yes	Fillable Fileable
Form and Instruction	2	MONAHRQ Professional End Users Focus Group protocol	OMB - Professional End Users FG protocol draft.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 64	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	64	64
Annual IC Time Burden (Hours)	96	96
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Cover Letter	OMB Cover Letter.doc	03/27/2015
Supporting Statement Part A	OMB - expedited Submission Form_MONAHRQ program evaluation_revised 03-26-15.docx	03/27/2015
Supporting Statement Part B	OMB - Part B ICR supporting statement MONAHRQ 1 14 15.docx	03/27/2015
• MONAHRQ Consumer End Users Focus Group protocol	OMB - Consumer End Users FG protocol draft.docx	03/27/2015
• MONAHRQ Professional End Users Focus Group protocol	OMB - Professional End Users FG protocol draft.docx	03/27/2015

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