View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

NIAMS Living With Resources Audience Feedback Through Focus Groups
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 1 Recruitment Screener English Attachment A_Patients and Family Caregivers Recruitment Screener_English.docx Yes Yes Fillable Fileable
Form 2 Recruitment Screener Spanish Attachment A1_Patients and Family Caregivers Recruitment Screener_Spanish.docx Yes Yes Fillable Fileable
Form 3 Health Worker Recruitment Screener Attachment B_Community Health Worker Recruitment Screener.docx Yes Yes Fillable Fileable
Form 4 Health Provider Professional Caregiver Recruitment Screener Attachment D_Healthcare Provider_Professional Caregiver Recruitment Screener.docx Yes Yes Fillable Fileable
Form 5 Consent Form English Attachment E_Consent Form_English.docx Yes Yes Fillable Fileable
Form 6 Consent Form Spanish Attachment E1_Consent Form_Spanish.docx Yes Yes Fillable Fileable
Instruction Attachment F_Booklet Review Instructions_English.docx Yes Yes Printable Only
Instruction Attachment F1_Booklet Review Instructions_Spanish.docx Yes Yes Printable Only
Form 7 Professionals Moderators Guide Attachment G_Professionals Moderators Guide.docx Yes Yes Fillable Fileable
Form 8 Patients and Family Caregivers Moderators Guide English Attachment H_Patients and Family Caregivers Moderators Guide_English.docx Yes Yes Fillable Fileable
Form 9 Patients and Family Caregivers Moderators Guide Spanish Attachment H1_Patients and Family Caregivers Moderators Guide_Spanish.docx Yes Yes Fillable Fileable

Health Health Care Services

 

378 0
   
Individuals or Households
 
   75 %

  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 378 0 378 0 0 0
Annual IC Time Burden (Hours) 143 0 143 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Template OMB FORM_NIAMS_Living With Focus Groups_0925-0648-2.21.24.docx 03/20/2024
Email Scripts Attachment C_ Professionals Recruitment Email Scripts.docx 03/20/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.