2018 NPIN Evaluation Focus Groups

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NCHHSTP)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1027 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-1027 2018 NPIN Evaluation Focus Groups Form and Instruction
0920-1027 NPIN Evaluation Screener NPIN Evaluation Screener.docx Form and Instruction
0920-1027 NPIN Evaluation Moderator Guide - Managers Att 1 MOD_GUIDE_MANAG.docx Form and Instruction
0920-1027 NPIN Evaluation Moderator Guide - Rank and File Att 2 MOD_GUIDE_RANK-FILE.doc Form and Instruction
Att 3 NPIN Eval Focus Group Consent.docx NPIN Evaluation Focus Group Consent IC Document
Att 4 Focus Group Additional Recruitment.docx NPIN Evaluation Recruitment Email IC Document
Att 5 Focus Group Confirmation.docx NPIN Evaluation Focus Group Confirmation Email IC Document
NPIN Framing Sample4-6.pdf NPIN Framing Sample IC Document
FastTrackSubmission NPIN-Focus Groups 30MAY2018.DOCX FastTrack GenIC Request IC Document

Information Collection (IC) Details

IC Title:	2018 NPIN Evaluation Focus Groups	Agency IC Tracking Number:	0920-1027-18AGK

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Electronic Capability
Form and Instruction	0920-1027	NPIN Evaluation Screener	NPIN Evaluation Screener.docx	NA	No	Paper Only
Form and Instruction	0920-1027	NPIN Evaluation Moderator Guide - Managers	Att 1 MOD_GUIDE_MANAG.docx	NA	No	Paper Only
Form and Instruction	0920-1027	NPIN Evaluation Moderator Guide - Rank and File	Att 2 MOD_GUIDE_RANK-FILE.doc	NA	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 240	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 Agency Discretion
Annual Number of Responses for this IC	240	240
Annual IC Time Burden (Hours)	163	163
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
NPIN Evaluation Focus Group Consent	Att 3 NPIN Eval Focus Group Consent.docx	05/29/2018
NPIN Evaluation Recruitment Email	Att 4 Focus Group Additional Recruitment.docx	05/29/2018
NPIN Evaluation Focus Group Confirmation Email	Att 5 Focus Group Confirmation.docx	05/29/2018
NPIN Framing Sample	NPIN Framing Sample4-6.pdf	05/29/2018
FastTrack GenIC Request	FastTrackSubmission NPIN-Focus Groups 30MAY2018.DOCX	05/29/2018

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