Information Collection

Family Focus Group Protocol

IC 267047 under ICR 202404-0906-005 · OMB 0906-0099.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 4 Family Focus Group Protocol	Form and Instruction
4 Family Focus Group Protocol Appendix G_Instrument 4_Family Focus Group Protocol.docx	Form and Instruction
4 Family Focus Group Protocol Appendix G_Disparities Instrument 4_Family Focus Group Protocol 08012024.docx	Form and Instruction
Appendix G_Disparities Instrument 4_Family Focus Group Protocol (RL).docx Appendix G_Disparities Instrument 4_Family Focus Group Protocol (RL)	IC Document

IC Title:

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	4	Family Focus Group Protocol	Appendix G_Disparities Instrument 4_Family Focus Group Protocol 08012024.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 64

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	64	64
Annual IC Time Burden (Hours)	64	64
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix G_Disparities Instrument 4_Family Focus Group Protocol (RL)	Appendix G_Disparities Instrument 4_Family Focus Group Protocol (RL).docx	08/01/2024

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