Information Collection Request

Evaluation of Patient-Centered Outcomes Research Trust Fund—Training Program

ICR 202001-0935-001 · OMB 0935-0250 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 3 Key Informant Interview Guide for K12 Program Directors Form and Instruction New Available
Form 2 Attachment B: K Awardee /K12 Scholar Primary Mentor Survey Form and Instruction New Available
Form 1 Attachment A: K Awardee Survey/K12 Scholar Survey Form and Instruction New Available
OMB_StatementA_PCORTFEval 01272020.docx Supporting Statement A Uploaded 2020-01-29 Available
Attachment G_Invitation message to be sent by AHRQ 11 07 19.docx Supplementary Document Uploaded 2020-01-28 Available
AttachmentF_Invitation message to be sent by AHRQ 11 07 19.docx Supplementary Document Uploaded 2020-01-28 Available
Attachement E_Invitation message to be sent by AHRQ 11 07 19.docx Supplementary Document Uploaded 2020-01-28 Available
OMB_StatementB_PCORTFEval 11 07 19.docx Supporting Statement B Uploaded 2020-01-28 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
239582 Key Informant Interview Guide for K12 Program Directors Form and Instruction NewKey Informant Interview Guide for K12 Program Directors
239581 Attachment B: K Awardee /K12 Scholar Primary Mentor Survey Form and Instruction NewAttachment B: K Awardee /K12 Scholar Primary Mentor Survey
239575 Attachment A: K Awardee Survey/K12 Scholar Survey Form and Instruction NewAttachment A: K Awardee Survey/K12 Scholar Survey

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
03/31/2023 36 Months From Approved
288 0 0
151 0 0
0 0 0





Reginfo record details
3
table that charts list of burden
IC Title Form No. Form Name
Attachment A: K Awardee Survey/K12 Scholar Survey 1
Attachment B: K Awardee /K12 Scholar Primary Mentor Survey 2
Key Informant Interview Guide for K12 Program Directors 3

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 288 0 0 288 0 0
Annual Time Burden (Hours) 151 0 0 151 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No