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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Appendix C1. PD Interview Guide
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
C1
Appendix C1. PD Interview Guide
Appendix C1. PD Discussion Guide_5-18-20.docx
Yes
Yes
Fillable Printable
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:
4
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:
50 %
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
4
0
4
0
0
0
Annual IC Time Burden (Hours)
4
0
4
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Appendix C2. PD Invitation Email
Appendix C2. PD Invitation Email.docx
06/05/2020
Appendix C3. PD Study Description/FAQs
Appendix C3. PD FAQs.docx
06/05/2020
Appendix C4. PD Invitation Reminder Email
Appendix C4. PD Invitation Reminder Email.docx
06/05/2020
Appendix C5. PD Telephone Recruitment Script
Appendix C5. PD Recruitment Telephone Script.docx
06/05/2020
Appendix C6. PD Scheduling Email
Appendix C6. PD Scheduling Email.docx
06/05/2020
Appendix C7. PD Confirmation Email
Appendix C7. PD Confirmation Email.docx
06/05/2020
Appendix C8. PD Reminder Email
Appendix C8. PD Interview Reminder Email.docx
06/05/2020
Appendix C9. PD Reminder Telephone Script
Appendix C9. PD Reminder Telephone Script.docx
06/05/2020
Appendix C10. PD Thank-You Email
Appendix C10. PD Thank You Email.docx
06/05/2020
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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