Information Collection

Information Gathering and Usability Testing to Harmonize AHRQ Data Tools

IC 234196 under ICR 201709-0935-001 · OMB 0935-0179.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0935-0179 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Information Gathering and Usability Testing to Harmonize AHRQ Data Tools	Form and Instruction
1 INTERVIEW DISCUSSION GUIDES Tool discussion guide.docx	Form and Instruction
Supporting Statement.docx Supporting Statement	IC Document
Cover Letter.doc Cover Letter	IC Document

IC Title:

Information Gathering and Usability Testing to Harmonize AHRQ Data Tools

Agency IC Tracking Number:

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 and Instruction	1	INTERVIEW DISCUSSION GUIDES	Tool discussion guide.docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 50

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement	Supporting Statement.docx	11/28/2018
Cover Letter	Cover Letter.doc	11/28/2018

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