Information Collection

MONAHRQ Program Evaluation End User Focus Groups Protocol

IC 215883 under ICR 201409-0935-009 · OMB 0935-0179.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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
â¢ MONAHRQ Consumer End Users Focus Group protocol	OMB - Consumer End Users FG protocol draft.docx	03/27/2015
â¢ 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.