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National Comprehensive Cancer Control Program Focus Groups
Development of an Evaluation Plan to Evaluate Grantee Attainment of Selected Activities of Comprehensive Cancer Priorities
OMB: 0920-0971
IC ID: 206292
OMB.report
HHS/CDC
OMB 0920-0971
ICR 201303-0920-015
IC 206292
( )
Documents and Forms
Document Name
Document Type
National Comprehensive Cancer Control Program Focus Groups
Form and Instruction
Att 8_Focus Group Moderator Guide_011413_Revised.docx
Other-Focus Group Moderator Guide
Focus Group Consent From
Att 12_Focus Group consent form_011413_Revised.doc
Form and Instruction
Att 9_Focus Group invitation email_011413_Revised.doc
Att 9_Focus Group invitation email_011413_Revised
IC Document
Att 10_Focus Group confirmation email_011413_Revised.doc
Att 10_Focus Group confirmation email_011413_Revised
IC Document
Att 11_Focus Group Questions and Answer_011413_Revised.doc
Att 11_Focus Group Questions and Answer_011413_Revised
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
National Comprehensive Cancer Control Program 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
None
Focus Group Consent From
Att 12_Focus Group consent form_011413_Revised.doc
Yes
No
Paper Only
Other-Focus Group Moderator Guide
Att 8_Focus Group Moderator Guide_011413_Revised.docx
Yes
No
Printable 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:
20
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
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
20
0
20
0
0
0
Annual IC Time Burden (Hours)
30
0
30
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Att 9_Focus Group invitation email_011413_Revised
Att 9_Focus Group invitation email_011413_Revised.doc
03/21/2013
Att 10_Focus Group confirmation email_011413_Revised
Att 10_Focus Group confirmation email_011413_Revised.doc
03/21/2013
Att 11_Focus Group Questions and Answer_011413_Revised
Att 11_Focus Group Questions and Answer_011413_Revised.doc
03/21/2013
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.