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Key Informant Interview Guide (Site Visits)
Taking Efficiency Interventions in Health Services Delivery to Scale
OMB: 0935-0221
IC ID: 212331
OMB.report
HHS/AHRQ
OMB 0935-0221
ICR 201407-0935-001
IC 212331
( )
Documents and Forms
Document Name
Document Type
Form 2
Key Informant Interview Guide (Site Visits)
Form and Instruction
2 Key Informant Interview Guide
Attachment B Key Informant Interviews.doc
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Key Informant Interview Guide (Site Visits)
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
2
Key Informant Interview Guide
Attachment B Key Informant Interviews.doc
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
19
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
38
0
38
0
0
0
Annual IC Time Burden (Hours)
19
0
19
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.