Focus groups

Evaluating a Pilot Mobile Health Program (CMS-10634)

OMB: 0938-1339

IC ID: 225195

Information Collection (IC) Details

View Information Collection (IC)

Focus groups
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-10634 Focus group: Subscribers 40400 OMB Appendix C1a [rev 01-20-2017 by OSORA PRA].pdf No   Paper Only
Form CMS-10634 Focus group: Subscribers (Spanish version) 40400 OMB Appendix C1b [rev 01-20-2017 by OSORA PRA].pdf No   Paper Only
Other-Text Messages to Recruit TEXT4BABY Subscribers for Focus Groups 40400 OMB Appendix C2.pdf No   Printable Only
Form CMS-10634 Focus Groups Call-In Script for Recruitment 40400 OMB Appendix C3.pdf No   Fillable Fileable
Other-Pilot mHealth Focus Group: Reminder Call and Email Templates 40400 OMB Appendix C4.pdf No   Printable Only
Form CMS-10634 Consent Form for Focus Groups for Evaluating a Pilot Mobile Health Program 40400 OMB Appendix C5.pdf No   Paper Only

Health Health Care Services

 

96 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 96 0 96 0 0 0
Annual IC Time Burden (Hours) 163 0 163 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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