Information Collection

Acceptability/Feasibility Assessment Among Clinical and Community Providers

IC 247958 under ICR 202103-0920-010 · OMB 0920-1357.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1357 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Acceptability/Feasibility Assessment Among Clinical and Community Providers	Form and Instruction
Participant Focus Group / Interview Guide Att 13_Provider focus group and interview guides.docx	Form and Instruction

IC Title:

Acceptability/Feasibility Assessment Among Clinical and Community Providers

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 and Instruction	n/a	Participant Focus Group / Interview Guide	Att 13_Provider focus group and interview guides.docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 33

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: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	33	33
Annual IC Time Burden (Hours)	33	33
Annual IC Cost Burden (Dollars)	1,082	1,082

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.