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MONAHRQ Program Evaluation End User Focus Groups Protocol
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
OMB: 0935-0179
IC ID: 215883
OMB.report
HHS/AHRQ
OMB 0935-0179
ICR 202009-0935-002
IC 215883
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0935-0179 can be found here:
2023-10-05 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
OMB - Consumer End Users FG protocol draft.docx
Instruction
2 MONAHRQ Professional End Users Focus Group protocol
OMB - Professional End Users FG protocol draft.docx
Form and Instruction
OMB Cover Letter.doc
Cover Letter
IC Document
OMB - expedited Submission Form_MONAHRQ program evaluation_revised 03-26-15.docx
Supporting Statement Part A
IC Document
OMB - Part B ICR supporting statement MONAHRQ 1 14 15.docx
Supporting Statement Part B
IC Document
OMB - Consumer End Users FG protocol draft.docx
• MONAHRQ Consumer End Users Focus Group protocol
IC Document
OMB - Professional End Users FG protocol draft.docx
• MONAHRQ Professional End Users Focus Group protocol
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
MONAHRQ Program Evaluation End User Focus Groups Protocol
Agency IC Tracking Number:
IC Status:
Unchanged
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
Instruction
OMB - Consumer End Users FG protocol draft.docx
Yes
Yes
Fillable Fileable
Form and Instruction
2
MONAHRQ Professional End Users Focus Group protocol
OMB - Professional End Users FG protocol draft.docx
Yes
Yes
Fillable Fileable
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:
64
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Requested
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
64
0
0
0
0
64
Annual IC Time Burden (Hours)
96
0
0
0
0
96
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Cover Letter
OMB Cover Letter.doc
03/27/2015
Supporting Statement Part A
OMB - expedited Submission Form_MONAHRQ program evaluation_revised 03-26-15.docx
03/27/2015
Supporting Statement Part B
OMB - Part B ICR supporting statement MONAHRQ 1 14 15.docx
03/27/2015
• MONAHRQ Consumer End Users Focus Group protocol
OMB - Consumer End Users FG protocol draft.docx
03/27/2015
• MONAHRQ Professional End Users Focus Group protocol
OMB - Professional End Users FG protocol draft.docx
03/27/2015
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.