Information Collection

Health Services and Primary Care Research (HSPCR) Study, Stakeholder Interviews

IC 234568 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⚠️ Notice: This information collection may be referencing outdated material.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 Health Services and Primary Care Research (HSPCR) Study, Stakeholder Interviews	Form and Instruction
1 HSPCR Interview Guide: Other Stakeholders in HSR and PCR Interview Guide_HSPCR_Other Stakeholders_2018 12 18 v2.docx	Form and Instruction
2 HSPCR Interview Guide: Researchers in HSR and PCR Interview Guide_HSPCR_Researchers_2018 12 18 v2.docx	Form and Instruction
Email Recruitment template_Interview_HSPCR 2018 12 18.docx Email Recruitment template	IC Document
Project Information Sheet_Interview_HSPCR_2018 12 18.docx Project Information Sheet	IC Document
Cover Letter.doc Cover Letter	IC Document
HSPCR Submission Form_2018 12 14.docx Supporting Statement	IC Document

IC Title:

Health Services and Primary Care Research (HSPCR) Study, Stakeholder Interviews

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	HSPCR Interview Guide: Other Stakeholders in HSR and PCR	Interview Guide_HSPCR_Other Stakeholders_2018 12 18 v2.docx		No		Paper Only
Form and Instruction	2	HSPCR Interview Guide: Researchers in HSR and PCR	Interview Guide_HSPCR_Researchers_2018 12 18 v2.docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 40

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

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	40	40
Annual IC Time Burden (Hours)	60	60
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Email Recruitment template	Email Recruitment template_Interview_HSPCR 2018 12 18.docx	12/19/2018
Project Information Sheet	Project Information Sheet_Interview_HSPCR_2018 12 18.docx	12/19/2018
Cover Letter	Cover Letter.doc	12/19/2018
Supporting Statement	HSPCR Submission Form_2018 12 14.docx	12/21/2018

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