Information Collection

Staff Focus Group

IC 215075 under ICR 201701-0990-003 · OMB 0990-0428.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
0990-New_PAF Instrument 2_Master Protocol For Small Group Interviews.docx	Other-Guide
0990-_New_PAF_Attachment C_ConsentAssent Forms.docx Consent Letters and Forms and Youth Assent Form for Focus groups	IC Document

IC Title:

Staff Focus Group

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

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-Guide			0990-New_PAF Instrument 2_Master Protocol For Small Group Interviews.docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 13

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	13	13
Annual IC Time Burden (Hours)	13	13
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Consent Letters and Forms and Youth Assent Form for Focus groups	0990-_New_PAF_Attachment C_ConsentAssent Forms.docx	02/24/2015

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