Focus Group Participant Feedback Survey for HHS Region II Pilot Curriculum

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⚠️ Notice: This information collection may be referencing outdated material.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 0990-0379 can be found here:

Documents and Forms

Document Name Document Type
0990-0379Final Focus Group Participant Feedback Form (2).docx Other-Survey
0990-0379Final HHS OASH Reg II Generic_Clearance_Submission (2).docx Focus Group Participant Feedback Survey for HHS Region II Pilot Curriculum IC Document

Information Collection (IC) Details

IC Title:	Focus Group Participant Feedback Survey for HHS Region II Pilot Curriculum	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
Other-Survey			0990-0379Final Focus Group Participant Feedback Form (2).docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 48	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	48	48
Annual IC Time Burden (Hours)	2	2
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Focus Group Participant Feedback Survey for HHS Region II Pilot Curriculum	0990-0379Final HHS OASH Reg II Generic_Clearance_Submission (2).docx	08/04/2015

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