Information Collection

Focus Group Study of Healthcare Provider Knowledge of Biosimilar Biological Products - Phase 2

IC 217649 under ICR 201412-0910-003 · OMB 0910-0687.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Recruitment Screener.doc	Other-Questionnaire
OMB Justification for Generic Clearance for Focus Group Study of Healthcare Provider Knowledge of BPP - Phase 2.doc OMB Justification for Generic Clearance for Focus Group Study of Healthcare Provider Knowledge of Biosimilar Biological Products	IC Document
Interview Guide - Template.doc Interview Guide	IC Document
Consent Form - Pharmacists.docx Consent Form - Pharmacists	IC Document
Consent Form - Physicians.docx Consent Form - Physicians	IC Document
CITI IRB Training Certificate (Rupert).pdf Training Certificate (Rupert)	IC Document
CITI IRB Training Certificate (Scales).pdf Training Certificate (Scales)	IC Document
CITI_Lappin.pdf Training Certificate (Lappin)	IC Document
RE Incentives.msg Recommendation on Incentives from OMB	IC Document

IC Title:

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
Other-Questionnaire			Recruitment Screener.doc		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 81

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	81	81
Annual IC Time Burden (Hours)	29	29
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB Justification for Generic Clearance for Focus Group Study of Healthcare Provider Knowledge of Biosimilar Biological Products	OMB Justification for Generic Clearance for Focus Group Study of Healthcare Provider Knowledge of BPP - Phase 2.doc	07/24/2015
Interview Guide	Interview Guide - Template.doc	07/24/2015
Consent Form - Pharmacists	Consent Form - Pharmacists.docx	07/24/2015
Consent Form - Physicians	Consent Form - Physicians.docx	07/24/2015
Training Certificate (Rupert)	CITI IRB Training Certificate (Rupert).pdf	07/24/2015
Training Certificate (Scales)	CITI IRB Training Certificate (Scales).pdf	07/24/2015
Training Certificate (Lappin)	CITI_Lappin.pdf	07/24/2015
Recommendation on Incentives from OMB	RE Incentives.msg	07/24/2015

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