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Semi-structured interviews for the draft manual
Connecting Primary Care Practices with Hard-to-Reach Adolescent Populations
OMB: 0935-0184
IC ID: 197276
OMB.report
HHS/AHRQ
OMB 0935-0184
ICR 201104-0935-003
IC 197276
( )
Documents and Forms
Document Name
Document Type
Form Form #11
Semi-structured interviews for the draft manual
Form and Instruction
Form #11 Review of Draft Manual Interview Guide
Attachment M -- Review of Draft Manual Interview Guide.doc
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Semi-structured interviews for the draft manual
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 #11
Review of Draft Manual Interview Guide
Attachment M -- Review of Draft Manual Interview Guide.doc
Yes
Yes
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Immunization Management
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
4
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
8
0
8
0
0
0
Annual IC Time Burden (Hours)
8
0
8
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.