Information Collection

Focus Group Participant Characteristics Form – All Phases

IC 267003 under ICR 202407-0906-007 · OMB 0906-0095.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0906-0095 can be found here:

Documents and Forms

Document Name Document Type
Form 9 Focus Group Participant Characteristics Form – All Phases Form and Instruction
9 Focus Group Participant Characteristics- All Phases Coac Focus Group Participant Characteristics – All Phases Coaching_Instrument.docx Form and Instruction
9 Focus Group Participant Characteristics- All Phases Coac Focus Group Participant Characteristics – All Phases Coaching_Instrument.docx Form and Instruction
9 Instrument 9- MCHB- Assessing the Use of Coaching - 6.5. Instrument 9- MCHB- Assessing the Use of Coaching - 6.5.24-Tracked.docx Form and Instruction
9 Instrument 9- MCHB- Assessing the Use of Coaching - 6.5. Instrument 9- MCHB- Assessing the Use of Coaching - 6.5.24-Tracked.docx Form and Instruction
9 Instrument 9- MCHB- Assessing the Use of Coaching -6.5.2 Instrument 9- MCHB- Assessing the Use of Coaching -6.5.24.docx Form and Instruction
9 Instrument 9- MCHB- Assessing the Use of Coaching -6.5.2 Instrument 9- MCHB- Assessing the Use of Coaching -6.5.24.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Focus Group Participant Characteristics Form â All Phases	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	9	Focus Group Participant Characteristics- All Phases Coaching Instrument	Focus Group Participant Characteristics â All Phases Coaching_Instrument.docx	Yes	Yes	Fillable Fileable
Form and Instruction	9	Instrument 9- MCHB- Assessing the Use of Coaching - 6.5.24-Tracked	Instrument 9- MCHB- Assessing the Use of Coaching - 6.5.24-Tracked.docx	Yes	Yes	Fillable Fileable
Form and Instruction	9	Instrument 9- MCHB- Assessing the Use of Coaching -6.5.24	Instrument 9- MCHB- Assessing the Use of Coaching -6.5.24.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: 72

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)	10	10
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.