Appendix A1. Scholar Interview Guide

Evaluation of Learning Health Systems K12 Training Program

Documents and Forms

Document Name Document Type
Form A1 Appendix A1. Scholar Interview Guide Form and Instruction
A1 Appendix A1. Scholar Interview Guide Appendix A1. Scholar Discussion Guide_5-18-20.docx Form and Instruction
Appendix A2. Scholar Invitation Email.docx Appendix A2. Scholar Invitation Email IC Document
Appendix A3. Scholar FAQs.docx Appendix A3. Scholar Study Description/FAQs IC Document
Appendix A4. Scholar Invitation Reminder Email.docx Appendix A4. Scholar Invitation Reminder Email IC Document
Appendix A5. Scholar Recruitment Telephone Script.docx Appendix A5. Scholar Telephone Recruitment Script IC Document
Appendix A6. Scholar Scheduling Email.docx Appendix A6. Scholar Scheduling Email IC Document
Appendix A7. Scholar Confirmation Email.docx Appendix A7. Scholar Confirmation Email IC Document
Appendix A8. Scholar Interview Reminder Email.docx Appendix A8. Scholar Reminder Email IC Document
Appendix A9. Scholar Reminder Telephone Script.docx Appendix A9. Scholar Reminder Telephone Script IC Document
Appendix A10. Scholar Thank You Email.docx Appendix A10. Scholar Thank-You Email IC Document

Information Collection (IC) Details

IC Title:	Appendix A1. Scholar Interview Guide	Agency IC Tracking Number:

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	A1	Appendix A1. Scholar Interview Guide	Appendix A1. Scholar Discussion Guide_5-18-20.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 41	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: 50 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	41	41
Annual IC Time Burden (Hours)	41	41
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Appendix A2. Scholar Invitation Email	Appendix A2. Scholar Invitation Email.docx	06/05/2020
Appendix A3. Scholar Study Description/FAQs	Appendix A3. Scholar FAQs.docx	06/05/2020
Appendix A4. Scholar Invitation Reminder Email	Appendix A4. Scholar Invitation Reminder Email.docx	06/05/2020
Appendix A5. Scholar Telephone Recruitment Script	Appendix A5. Scholar Recruitment Telephone Script.docx	06/05/2020
Appendix A6. Scholar Scheduling Email	Appendix A6. Scholar Scheduling Email.docx	06/05/2020
Appendix A7. Scholar Confirmation Email	Appendix A7. Scholar Confirmation Email.docx	06/05/2020
Appendix A8. Scholar Reminder Email	Appendix A8. Scholar Interview Reminder Email.docx	06/05/2020
Appendix A9. Scholar Reminder Telephone Script	Appendix A9. Scholar Reminder Telephone Script.docx	06/05/2020
Appendix A10. Scholar Thank-You Email	Appendix A10. Scholar Thank You Email.docx	06/05/2020

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