Information Collection

Information Gathering and Usability Testing to Harmonize AHRQ Data Tools

IC 234196 under ICR 202501-0935-001 · OMB 0935-0179.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Information Gathering and Usability Testing to Harmonize AHRQ Data Tools	Form and Instruction
Form 1 INTERVIEW DISCUSSION GUIDES Information Gathering and Usability Testing to Harmonize AHRQ Data Tools	Form and Instruction
1 INTERVIEW DISCUSSION GUIDES Tool discussion guide.docx	Form and Instruction
1 INTERVIEW DISCUSSION GUIDES Tool discussion guide.docx	Form and Instruction
Supporting Statement.docx Supporting Statement	IC Document
Supporting Statement.docx Supporting Statement	IC Document
Cover Letter.doc Cover Letter	IC Document
Cover Letter.doc Cover Letter	IC Document

IC Title:

Agency IC Tracking Number:

IC Status: Removed

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	1				No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 50

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-50	50
Annual IC Time Burden (Hours)	-50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement		11/28/2018
Cover Letter		11/28/2018

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

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