Information Collection

Virtual Focus Groups for Exploratory Research with Primary Care Physicians - Hepatitis C

IC 228702 under ICR 201705-0920-017 · OMB 0920-1027.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1027 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Virtual Focus Groups for Exploratory Research with Primary Care Physicians - Hepatitis C	Form
Att 2 ModeratorDiscussion Guide Hepatitis C.docx	Other-Focus Group Guide
Screener Att 1 Screener 2017 Physician Discussion Group.docx	Form
Generic Clearance for Qualitative Feedback Template.docx Request for Approval	IC Document

IC Title:

Virtual Focus Groups for Exploratory Research with Primary Care Physicians - Hepatitis C

Agency IC Tracking Number:

0920-1027-18CJ

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
Form	none	Screener	Att 1 Screener 2017 Physician Discussion Group.docx		Yes	Yes	Fillable Fileable
Other-Focus Group Guide			Att 2 ModeratorDiscussion Guide Hepatitis C.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 496

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	496	496
Annual IC Time Burden (Hours)	187	187
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Request for Approval	Generic Clearance for Qualitative Feedback Template.docx	10/18/2017

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