OMB control number

Connecting Primary Care Practices with Hard-to-Reach Adolescent Populations

OMB 0935-0184 · HHS/AHRQ.

OMB 0935-0184

Latest Forms, Documents, and Supporting Material

Document Name
Form Form #11 Semi-structured interviews for the draft manual Form and Instruction
Form Form #10 Administrator-staff semi-structured interviews Form and Instruction
Form Form #9 Clinician semi-structured interviews Form and Instruction
Form Form #8 Adolescent "think-aloud" sessions Form and Instruction
Form Form #7 Adolescent focus groups Form and Instruction
Form Form #6 Post-visit satisfaction survey Form and Instruction
Form Form #5 Adolescent behavior and communication survey Form and Instruction
Form Form #3 Adolescent behavior and communication survey consent-assent form Form and Instruction
Form Form #2 Extraction of medical record data Form and Instruction
Form Form #1 RAAPS questionnaire Form and Instruction
Supporting Statement Part B -- Connecting PCP with Hard to Reach Adolescent Pop 3-8-2011.doc Supporting Statement B
Attachment A -- Healthcare Research and Quality Act of 1999.pdf Supplementary Document
Attachment N -- Federal Register Notice.pdf Supplementary Document
Attachment D -- Adolescent Behavior and Communication Survey Information Letter.doc Supplementary Document
Supporting Statement Part A -- Connecting PCP with Hard to Reach Adolescent Pop 9-12-2011.doc Supporting Statement A
Semi-structured interviews for the draft manual Form and Instruction
Administrator-staff semi-structured interviews Form and Instruction
Clinician semi-structured interviews Form and Instruction
Adolescent "think-aloud" sessions Form and Instruction
Adolescent focus groups Form and Instruction
Post-visit satisfaction survey Form and Instruction
Adolescent behavior and communication survey Form and Instruction
Adolescent behavior and communication survey consent-assent form Form and Instruction
Extraction of medical record data Form and Instruction
RAAPS questionnaire Form and Instruction

All Historical Document Collections

201104-0935-003

Approved with change

New collection (Request for a new OMB Control Number)

2011-04-12