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

Latest forms, documents, and information collections
Document	Type
Form Form #10 Key Informant Interview Guides	Form and Instruction
Form Form #9 Moderator Guide and Respondent Materials for Patients - Mixed Ages	Form and Instruction
Form Form #8 Moderator Guide and Respondent Materials for Patients Ages 18+	Form and Instruction
Form Form #7 Moderator Guide and Respondent Materials for Patients Ages 14-17	Form and Instruction
Form Form #6 Moderator Guide and Respondent Materials for Patients Ages 9-13	Form and Instruction
Form Form #5 Moderator Guide for IT Developers	Form and Instruction
Form Form #4 Moderator Guide and Respondent Materials for Parents/Caregivers	Form and Instruction
Form Form #3 Moderator Guide and Respondent Materials for Providers	Form and Instruction
Form Form #2 Demographic Questionnaires	Form and Instruction
Form Form #1 Focus Group Screening Questionnaires	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All Historical Document Collections

Historical document collections
Reference	Filing	Received	Concluded	Action
201305-0935-002	New collection (Request for a new OMB Control Number)	2013-05-20		Approved without change