View Information Collection (IC)
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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Foundational Focus Groups
Agency IC Tracking Number:
Is this a Common Form?
No
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
Other-FFG- Part A, Attachment D
Part A - Attachment D_Foundational FGs Invitation Emails.docx
Yes
Yes
Fillable Fileable
Other-FFG-Part A, Attachment E
Part A - Attachment E_ Foundational FGs Screener_122420.docx
Yes
Yes
Fillable Fileable
Other-FFG-Part A, Attachment F
Part A - Attachment F_Foundational FGs Informed Consent Form_122420.docx
Yes
Yes
Fillable Fileable
Other-FFG-Part A, Attachment G
Part A - Attachment G_Foundational FGs External IRB Determination.pdf
Yes
Yes
Fillable Fileable
Other-FFG-Part B, Attachment B
Part B - Attachment B_Foundational FGs Discussion Guide_011821.docx
Yes
Yes
Fillable Fileable
Other-Screener - Definite Waiters
BRCFB8~1.PDF
Yes
Yes
Fillable Fileable
Other-Screener - American Indian
BRANYI~2.PDF
Yes
Yes
Fillable Fileable
Other-Screener - Asian american
BRANYI~3.PDF
Yes
Yes
Fillable Fileable
Other-Screener - African American
BRANYI~4.PDF
Yes
Yes
Fillable Fileable
Other-Screener - Hispanic
BR1E56~1.PDF
Yes
Yes
Fillable Fileable
Other-Screener - Native Hawaiian
BR6545~1.PDF
Yes
Yes
Fillable Fileable
Other-Screener - Unsure Waiters
BR250A~1.PDF
Yes
Yes
Fillable Fileable
Other-Screener - Vaccinated Gen Pop
BR91F4~1.PDF
Yes
Yes
Fillable Fileable
Other-Testing-Screener-7-12-21
HHS COVID-19 Creative Testing Wave 2 Screener July 12_clean.docx
Yes
Yes
Fillable Fileable
Other-Adult Screener
BRANY IRB Approved Materials - HHS COVID-19 Public Education Campaign_W2 FFG Screener_Adults_11-03-21.pdf
Yes
Yes
Fillable Fileable
Other-Parents Screener
BRANY IRB Approved Materials - HHS COVID-19 Public Education Campaign_W2 FFG Screener_Parents_11-03-21.pdf
Yes
Yes
Fillable Fileable
Other-Parent FG Screener 3-17-22
HHS COVID-19 Parent FG Screener Final.docx
Yes
Yes
Fillable Fileable
Other-FFG Parent FG Screener 04-12-23
HHS COVID-19 Parent FG_Screener_track changes_04-12-23.docx
Yes
Yes
Fillable Fileable
Other-FFG Parent FG Discussion Guide 04-12-23
HHS COVID-19 Parent FG_Discussion Guide_track changes_04-12-23.docx
Yes
Yes
Fillable Fileable
Other-FFG_Rebrand FG Discussion Guide 06-05-23
HHS COVID-19 WCDT Brand FG_Discussion Guide 06-02-23.docx
Yes
Yes
Fillable Fileable
Other-FFG_Rebrand FG Screener 06-05-23
HHS COVID-19 WCDT Brand FG_Screener 06-02-23.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:
50,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
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
50,000
0
0
0
0
50,000
Annual IC Time Burden (Hours)
7,750
0
0
0
0
7,750
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.