Information Collection

Focus Group-Residents and Family

IC 242980 under ICR 202008-0985-001 · OMB 0985-0069.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Focus Group-Residents and Family	Form
0985-New Draft Focus Group Guide_Residents and Family Members (6).pdf	Other-Focus Group Guide
Focus Group Residents and Family Members 0985-New Draft Focus Group Participant Info_Residents and Family Members (1).pdf	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

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	NA	Focus Group Residents and Family Members	0985-New Draft Focus Group Participant Info_Residents and Family Members (1).pdf		Yes	Yes	Fillable Fileable
Other-Focus Group Guide			0985-New Draft Focus Group Guide_Residents and Family Members (6).pdf		Yes	No	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 24

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	24	24
Annual IC Time Burden (Hours)	24	24
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.