OMB
	Control # 0584-0524
	| Expiration: 06/30/2016 |Page 
	
Attachment D: Worksheet For Parent/Caregiver Focus Groups (English Version)
OMB BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0584-0524. The time to complete this information collection is estimated as part of the 90-minute focus group interview, including time to complete and review the information collection.
DATE _____________ GROUP ____________ LOCATION _____________
| What did you think about the information you saw today? Please grade each section from A to F, where A is "excellent" and F is "failing": | |||||
| Overall | A | B | C | D | F | 
| Infographic | A | B | C | D | F | 
| Handout - Front Page | A | B | C | D | F | 
| Handout - Inside Pages | A | B | C | D | F | 
| Handout - Back Page | A | B | C | D | F | 
	What
	information was the most
	useful
	to you and why? 
	What
	is the overall
	message
	of this handout? What is it trying to tell you? 
 
	Is
	there anything you think you will do
	differently
	after reading the information in this handout?  
	
	 
	
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document | 
| Author | Gerad O'Shea | 
| File Modified | 0000-00-00 | 
| File Created | 2021-01-23 |