Information Collection

Focus Group for Primary Care Providers Regarding Alcohol Treatment (NIAAA)

IC 236478 under ICR 202104-0925-001 · OMB 0925-0648.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Focus Group for Primary Care Providers Regarding Alcohol Treatment (NIAAA)	Form and Instruction
1 Navigator Screener Round 2 V2Navigator Screener Round 2 mFINAL.docx	Form and Instruction
1 Navigator Screener Round 2 V2Navigator Screener Round 2 mFINAL.docx	Form and Instruction
2 Physicians Moderator Guide V2NPs-PAs--Physicians Moderator Guide ROUND 2 FINAL.docx	Form and Instruction
2 Physicians Moderator Guide V2NPs-PAs--Physicians Moderator Guide ROUND 2 FINAL.docx	Form and Instruction
V2Fast Track ICR Form - NIAAA Navigator Focus Group_FINAL.doc Fast Track Form Navigator Focus Group	IC Document
V2Fast Track ICR Form - NIAAA Navigator Focus Group_FINAL.doc Fast Track Form Navigator Focus Group	IC Document
V2NIAAA Focus Group - Round 2 - All Assets FINAL.pptx Focus Group Round 2 All Assets	IC Document
V2NIAAA Focus Group - Round 2 - All Assets FINAL.pptx Focus Group Round 2 All Assets	IC Document

IC Title:

Focus Group for Primary Care Providers Regarding Alcohol Treatment (NIAAA)

Agency IC Tracking Number:

IC Status: Unchanged

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	1	Navigator Screener Round 2	V2Navigator Screener Round 2 mFINAL.docx		No		Paper Only
Form and Instruction	2	Physicians Moderator Guide	V2NPs-PAs--Physicians Moderator Guide ROUND 2 FINAL.docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 42

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 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	42	42
Annual IC Time Burden (Hours)	20	20
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast Track Form Navigator Focus Group	V2Fast Track ICR Form - NIAAA Navigator Focus Group_FINAL.doc	06/13/2019
Focus Group Round 2 All Assets	V2NIAAA Focus Group - Round 2 - All Assets FINAL.pptx	06/13/2019

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