Information Collection Request

Qualitative Study of Factors that Influence Healthcare Seeking in Pilots

ICR 202310-0701-002 · OMB 0701-0172 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
0701-TPHB_Non-Trainee_Informed Consent.docx Supplementary Document Uploaded 2023-10-16 Repair queued
0701-TPHB_Trainee_Informed Consent.pdf Supplementary Document Uploaded 2023-10-16 Repair queued
0701-TPHB_Non-Trainee_Solicitation.docx Supplementary Document Uploaded 2023-10-16 Repair queued
0701-TPHB_Trainee_Solicitation.docx Supplementary Document Uploaded 2023-10-16 Repair queued
0701-TPHB_Recruitment Posters.docx Supplementary Document Uploaded 2023-10-16 Repair queued
0701-TPHB_SSB_10.4.2023.docx Supporting Statement B Uploaded 2023-10-16 Repair queued
0701-TPHB_SSA_10.13.2023.docx Supporting Statement A Uploaded 2023-11-02 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
262831 Qualitative Study of Factors that Influence Healthcare Seeking in Pilots: Enrollment and Interviews Other-Screener Survey New

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved
100 0
80 0
4,000 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Qualitative Study of Factors that Influence Healthcare Seeking in Pilots: Enrollment and Interviews

table that charts list of burden
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 100 0 0 100 0 0
Annual Time Burden (Hours) 80 0 0 80 0 0
Annual Cost Burden (Dollars) 4,000 0 0 4,000 0 0


Reginfo record details
  No