Information Collection

Air Force Embedded Provider Semi-Structured Interview Guide

IC 246122 under ICR 202103-0701-001 · OMB 0701-0167.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Air Force Embedded Provider Semi-Structured Interview Guide_revised 15 March 21 (1).docx	Other-Survey
Air Force Embedded Provider Semi-Structured Interview Guide_revised 15 March 21 (1).docx	Other-Survey

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
Other-Survey					Yes	Yes	Fillable Fileable Signable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 30

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	30	30
Annual IC Time Burden (Hours)	45	45
Annual IC Cost Burden (Dollars)	2,250	2,250

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.

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