Information Collection

Key Informant Interview Guide and Consent

IC 236526 under ICR 201906-0920-006 · OMB 0920-1270.

Documents and Forms

Document Name Document Type
Form 0920-19MM Key Informant Interview Guide and Consent Form and Instruction
0920-19MM Key Informant interview guide Att 5d - Key informant interview guide & informed consent DS final.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Key Informant Interview Guide and Consent	Agency IC Tracking Number:	0920-19MM

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-19MM	Key Informant interview guide	Att 5d - Key informant interview guide & informed consent DS final.docx		No		Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 12	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	12	12
Annual IC Time Burden (Hours)	12	12
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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