View Information Collection (IC)

View Information Collection (IC)

IC Title:	WHR Consumer Focus Group Survey	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
Form and Instruction	1	WHR Consumer Focus Group Survey	NLM-WHR-Consumer_Focus_Group-Survey Instrument.docx		Yes	Yes	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: 24	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	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	24	0	0	0	0	24
Annual IC Time Burden (Hours)	36	0	0	0	0	36
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
NLM Generic Clearance Request Form_WHR Consumer Focus Group	NLM Generic Clearance Request Form_WHR Consumer Focus Group.doc	10/05/2012
NLM WHR Consumer Focus Group Mini-Supporting Statement	NLM WHR Consumer Focus Group Mini-Supporting Statement .docx	10/05/2012

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