Information Collection

2018 NPIN Evaluation Focus Groups

IC 231521 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⚠️ Notice: This information collection may be referencing outdated material.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
Form 0920-1027 2018 NPIN Evaluation Focus Groups	Form and Instruction
0920-1027 NPIN Evaluation Screener NPIN Evaluation Screener.docx	Form and Instruction
0920-1027 NPIN Evaluation Moderator Guide - Managers Att 1 MOD_GUIDE_MANAG.docx	Form and Instruction
0920-1027 NPIN Evaluation Moderator Guide - Rank and File Att 2 MOD_GUIDE_RANK-FILE.doc	Form and Instruction
Att 3 NPIN Eval Focus Group Consent.docx NPIN Evaluation Focus Group Consent	IC Document
Att 4 Focus Group Additional Recruitment.docx NPIN Evaluation Recruitment Email	IC Document
Att 5 Focus Group Confirmation.docx NPIN Evaluation Focus Group Confirmation Email	IC Document
NPIN Framing Sample4-6.pdf NPIN Framing Sample	IC Document
FastTrackSubmission NPIN-Focus Groups 30MAY2018.DOCX FastTrack GenIC Request	IC Document

IC Title:

2018 NPIN Evaluation Focus Groups

Agency IC Tracking Number:

0920-1027-18AGK

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?	Electronic Capability
Form and Instruction	0920-1027	NPIN Evaluation Screener	NPIN Evaluation Screener.docx	NA	No	Paper Only
Form and Instruction	0920-1027	NPIN Evaluation Moderator Guide - Managers	Att 1 MOD_GUIDE_MANAG.docx	NA	No	Paper Only
Form and Instruction	0920-1027	NPIN Evaluation Moderator Guide - Rank and File	Att 2 MOD_GUIDE_RANK-FILE.doc	NA	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: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

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)	163	163
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
NPIN Evaluation Focus Group Consent	Att 3 NPIN Eval Focus Group Consent.docx	05/29/2018
NPIN Evaluation Recruitment Email	Att 4 Focus Group Additional Recruitment.docx	05/29/2018
NPIN Evaluation Focus Group Confirmation Email	Att 5 Focus Group Confirmation.docx	05/29/2018
NPIN Framing Sample	NPIN Framing Sample4-6.pdf	05/29/2018
FastTrack GenIC Request	FastTrackSubmission NPIN-Focus Groups 30MAY2018.DOCX	05/29/2018

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