Information Collection

Practice Facilitator Focus Groups

IC 258005 under ICR 202301-0935-002 · OMB 0935-0264.

Documents and Forms

Document Name Document Type
Form 1 Practice Facilitator Focus Groups Form and Instruction
1 Focus Group Protocol A-MUI_Practice facilitator_Focus Group Protocol (Base Year)_20Oct22.pdf Form and Instruction
1 Focus Group Protocol A-MUI_Practice facilitator_Focus Group Protocol (Base Year)_20Oct22.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Practice Facilitator Focus Groups	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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	Focus Group Protocol	A-MUI_Practice facilitator_Focus Group Protocol (Base Year)_20Oct22.pdf		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 45	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	45	45
Annual IC Time Burden (Hours)	45	45
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.