Information Collection

Focus Group Participant Characteristics Form

IC 269570 under ICR 202502-0906-004 · OMB 0906-0098.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 9 Focus Group Participant Characteristics Form	Form and Instruction
Form 9 0906-0098_MCHB_Focus Group Participant Characteristics Form_Redline_02282025.docx Focus Group Participant Characteristics Form	Form and Instruction
9 0906-0098_MCHB_Focus Group Participant Characteristics F 0906-0098_MCHB_Focus Group Participant Characteristics Form_Redline_02282025.docx	Form and Instruction
9 0906-0098_MCHB_Focus Group Participant Characteristics F 0906-0098_MCHB_Focus Group Participant Characteristics Form_Redline_02282025.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	9				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 %

table that charts list of burden
	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

table that charts IC Documents
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.

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