OMB control number

Improving Sickle Cell Transitions of Care through Health Information Technology Phase 1

OMB 0935-0213 · HHS/AHRQ.

OMB 0935-0213

Latest Forms, Documents, and Supporting Material

Document Name
Form Form #10 Key Informant Interviews Form and Instruction
Form Form #9 Patients mixed ages Focus Group Form and Instruction
Form Form #8 Patients 18 & older Focus Group Form and Instruction
Form Form #7 Patients 14-17 Focus Group Form and Instruction
Form Form #6 Patients 9-13 Focus Group Form and Instruction
Form Form #5 IT Developer Focus Group Form and Instruction
Form Form #4 Parent/Caregiver Focus Groups Form and Instruction
Form Form #3 Provider Focus Groups Form and Instruction
Form Form #2 Demographic Questionnaire Form and Instruction
Form Form #1 Focus Group Screener Form and Instruction
SS Part B -- Improving Sickle Cell Transitions of Care through HIT Phase 1 3-7-2013.doc Supporting Statement B
Attachment 13 - Justification of Focus Group Allocation by Site.docx Supplementary Document
Attachment 12 - Part A Bibliographical References.docx Supplementary Document
Attachment 11 - Consent & Assent Forms.doc Supplementary Document
Attachment 10 - Federal Register Notice.doc Supplementary Document
SS Part A -- Improving Sickle Cell Transitions of Care through HIT Phase 1 01-17-2013.doc Supporting Statement A
Key Informant Interviews Form and Instruction
Patients mixed ages Focus Group Form and Instruction
Patients 18 & older Focus Group Form and Instruction
Patients 14-17 Focus Group Form and Instruction
Patients 9-13 Focus Group Form and Instruction
IT Developer Focus Group Form and Instruction
Parent/Caregiver Focus Groups Form and Instruction
Provider Focus Groups Form and Instruction
Demographic Questionnaire Form and Instruction
Focus Group Screener Form and Instruction

All Historical Document Collections

201305-0935-002

Approved without change

New collection (Request for a new OMB Control Number)

2013-05-20