Information Collection

Focus Groups

IC 227987 under ICR 201612-0990-003 · OMB 0990-0462.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
OWH_OMB FG ICF_081517.docx	Other-survey
OWH_Draft FG Guide_081517.docx guide	IC Document

IC Title:

Focus Groups

Agency IC Tracking Number:

Is this a Common Form? No

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-survey					No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 240

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	240	240
Annual IC Time Burden (Hours)	360	360
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
guide		08/22/2017

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

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