OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Beneficiary Focus Groups

IC 226870 under ICR 201705-0938-008 · OMB 0938-1332.

Documents and Forms
Document Name
Document Type
Form and Instruction
Other-Telephone Recruitment Script
Form and Instruction
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Beneficiary Focus Groups
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10625 Core Focus Group Moderator’s Guide FGModGuide_HELP_27Feb2017_508.docx No   Paper Only
Other-Telephone Recruitment Script MT_FGRecruitmentScript (OMB Passback 1)_rev_clean.docx No   Paper Only

Health Health Care Services

 

60 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 60 0 60 0 0 0
Annual IC Time Burden (Hours) 180 0 180 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Participant Informed Consent Form Focus Group Participant Informed Consent_HELP-508_rev_clean.docx 06/23/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.