Focus Group Participant Characteristics Form

Assessing the Use of Informal Contacts to Promote Caregivers’ Engagement and Satisfaction with Early Childhood Home Visiting Through Rapid Cycle Learning

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0906-0098 can be found here:

Documents and Forms

Document Name Document Type
Form 9 Focus Group Participant Characteristics Form Form and Instruction
9 Focus Group Participant Characteristics Form Instrument 9- MCHB- ADAPT HV Informal Contacts- 6.10.24.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Focus Group Participant Characteristics Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

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	9	Focus Group Participant Characteristics Form	Instrument 9- MCHB- ADAPT HV Informal Contacts- 6.10.24.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 120	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	120	120
Annual IC Time Burden (Hours)	100	100
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.