Focus groups

Coordinating Care across Primary Care and Specialty Care Practices

Documents and Forms

Document Name Document Type
Form Form #1 Focus groups Form and Instruction
Form #1 Focus Group Guide Attachment B -- Focus Group Guide 4-24-09.doc Form and Instruction
Attachment C -- Focus Group Introduction.doc Attachment C -- Focus Group Introduction IC Document

Information Collection (IC) Details

IC Title:	Focus groups	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Form #1	Focus Group Guide	Attachment B -- Focus Group Guide 4-24-09.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	53	53
Annual IC Time Burden (Hours)	40	40
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment C -- Focus Group Introduction	Attachment C -- Focus Group Introduction.doc	05/20/2009

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