Information Collection

Focus Groups to Seek Input on NIH HEAL Initiative® Messaging on Pain Research

IC 270983 under ICR 202307-0925-004 · OMB 0925-0766.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form 1
Recruitment Screener—People Living with Pain and Caregivers Focus Groups to Seek Input on NIH HEAL Initiative® Messaging on Pain Research
Form
Form 2
Recruitment Screener—Family Caregivers Focus Groups to Seek Input on NIH HEAL Initiative® Messaging on Pain Research
Form
Form 3
Moderator’s Guide—People Living with Pain and Caregivers Focus Groups to Seek Input on NIH HEAL Initiative® Messaging on Pain Research
Form
Form 4
Consent Form—Consumers Focus Groups to Seek Input on NIH HEAL Initiative® Messaging on Pain Research
Form
Form 5
Recruitment Screener—Clinicians Focus Groups to Seek Input on NIH HEAL Initiative® Messaging on Pain Research
Form
Form 6
Moderator’s Guide—Clinicians Focus Groups to Seek Input on NIH HEAL Initiative® Messaging on Pain Research
Form
Form 7
Consent Form—Clinicians Focus Groups to Seek Input on NIH HEAL Initiative® Messaging on Pain Research
Form
1 Recruitment Screener—People Living with Pain and Caregiv
Attachment A_People with Pain Recruitment Screener.docx
Form
2 Recruitment Screener—Family Caregivers
Attachment B_Family Caregivers Recruitment Screener.docx
Form
3 Moderator’s Guide—People Living with Pain and Caregivers
Attachment E_HEAL Pain Message Testing Discussion Guide_PLWE and Caregivers.docx
Form
4 Consent Form—Consumers
Attachment F_HEAL Pain Message Testing Consumer Consent Form.docx
Form
5 Recruitment Screener—Clinicians
Attachment C_Clinician Recruitment Screener.docx
Form
6 Moderator’s Guide—Clinicians
Attachment D_HEAL Pain Message Testing Discussion Guide_Clinicians.docx
Form
7 Consent Form—Clinicians
Attachment G_HEAL Pain Message Testing Clinician Consent Form.docx
Form
Mini SSA_ HEAL Pain Message Testing.docx
Mini SSA
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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 1 Yes Yes Fillable Fileable
Form 2 Yes Yes Fillable Fileable
Form 3 Yes Yes Fillable Fileable
Form 4 Yes Yes Fillable Fileable
Form 5 Yes Yes Fillable Fileable
Form 6 Yes Yes Fillable Fileable
Form 7 Yes Yes Fillable Fileable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Approved 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 288 0 288 0 0 0
Annual IC Time Burden (Hours) 99 0 99 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
Mini SSA 09/16/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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