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Health Services and Primary Care Research (HSPCR) Study, Stakeholder Interviews
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
OMB: 0935-0179
IC ID: 234568
OMB.report
HHS/AHRQ
OMB 0935-0179
ICR 202009-0935-002
IC 234568
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0935-0179 can be found here:
2023-10-05 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 1
Health Services and Primary Care Research (HSPCR) Study, Stakeholder Interviews
Form and Instruction
1 HSPCR Interview Guide: Other Stakeholders in HSR and PCR
Interview Guide_HSPCR_Other Stakeholders_2018 12 18 v2.docx
Form and Instruction
2 HSPCR Interview Guide: Researchers in HSR and PCR
Interview Guide_HSPCR_Researchers_2018 12 18 v2.docx
Form and Instruction
Email Recruitment template_Interview_HSPCR 2018 12 18.docx
Email Recruitment template
IC Document
Project Information Sheet_Interview_HSPCR_2018 12 18.docx
Project Information Sheet
IC Document
Cover Letter.doc
Cover Letter
IC Document
HSPCR Submission Form_2018 12 14.docx
Supporting Statement
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Health Services and Primary Care Research (HSPCR) Study, Stakeholder Interviews
Agency IC Tracking Number:
IC Status:
Unchanged
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
1
HSPCR Interview Guide: Other Stakeholders in HSR and PCR
Interview Guide_HSPCR_Other Stakeholders_2018 12 18 v2.docx
No
Paper Only
Form and Instruction
2
HSPCR Interview Guide: Researchers in HSR and PCR
Interview Guide_HSPCR_Researchers_2018 12 18 v2.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
40
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
0 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
40
0
0
0
0
40
Annual IC Time Burden (Hours)
60
0
0
0
0
60
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Email Recruitment template
Email Recruitment template_Interview_HSPCR 2018 12 18.docx
12/19/2018
Project Information Sheet
Project Information Sheet_Interview_HSPCR_2018 12 18.docx
12/19/2018
Cover Letter
Cover Letter.doc
12/19/2018
Supporting Statement
HSPCR Submission Form_2018 12 14.docx
12/21/2018
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.