Information Collection Request

Embedded Research in Care Delivery Systems

ICR 201909-0935-002 · OMB 0935-0247 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1 Interview Protocol Form and Instruction New Available
Form 1 Interview Protocol Form and Instruction New Available
Form 1 E. Interview Protocol Form and Instruction New Available
OMB supporting statement A 7-12-19- clean_abrevisions.docx Supporting Statement A Uploaded 2019-10-01 Available
Attachment F-References.docx Supplementary Document Uploaded 2019-09-30 Available
Attachment D - with OMB language (2).docx Supplementary Document Uploaded 2019-09-30 Available
Attachment C Advance letters-revised.docx Supplementary Document Uploaded 2019-09-30 Available
Attachment B-Selection of interview subjects.docx Supplementary Document Uploaded 2019-09-30 Available
Attachment A Selection of Sites.docx Supplementary Document Uploaded 2019-09-30 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
237943 Interviews with researchers and other operations staff Form and Instruction NewInterview Protocol
237942 Interviews with physicians Form and Instruction NewInterview Protocol
237941 Interviews with executive-level subjects Form and Instruction NewE. Interview Protocol

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
12/31/2022 36 Months From Approved
74 0 0
74 0 0
0 0 0





Reginfo record details
3
table that charts list of burden
IC Title Form No. Form Name
Interviews with executive-level subjects 1
Interviews with physicians 1
Interviews with researchers and other operations staff 1

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 74 0 0 74 0 0
Annual Time Burden (Hours) 74 0 0 74 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No