Office of Assistant Secretary for Health

OASH

Federal Forms

Forms
OMB NumberTitle
0937-0213 FY2023 Teen Pregnancy Prevention Performance Measures
0937-0212 COVID-19 POST LEARNING COMMUNITY SURVEY
0937-0211 Ensuring Access to Equitable, Affordable, Client-centered, Quality Family Planning Services
0937-0210 COVID-19 by PCR Requisition Form
0937-0209 Youth Engagement in Sports (YES) Performance Measures
0937-0208 Fertility Knowledge Survey
0937-0207 SMARTool Pilot Replication Project
0937-0206 AIDS Drug Discovery and Development Industry Survey
0937-0205 Study of Consequences of Being Accused of Scientific Misconduct
0937-0204 Study to Evaluate the Effects of the Use of "Put Prevention into Practice" (PPIP) Materials in Primary Care Settings
0937-0203 VOLUNTARY "PARTNER" SURVEYS TO IMPLEMENT EXECUTIVE ORDER 12862 IN THE PUBLIC HEALTH SERVICE
0937-0202 STUDY OF THE CONSEQUENCES OF WHISTLEBLOWING
0937-0201 Voluntary Customer Surveys to Implement E.O. 12862 in the Public Health Service
0937-0200 HHS Payment Management System Forms PMS-270 - Request for Advance or Reimbursement and PMS-272 - Federal Cast Transaction Report
0937-0199 REQUEST FOR ADVANCE OR REIMBURSEMENT
0937-0198 Public Health Service Policies on Research Misconduct (42 CFR Part 93)
0937-0197 MINORITY COMMUNITY HEALTH COALITION DEMONSTRATION PROJECT EVALUATION STUDY
0937-0196 COMMUNITY AND MIGRANT HEALTH CENTER EMERGENCY PREPAREDNESS SURVEY
0937-0195 PUBLIC HEALTH SYSTEM IMPACT STATEMENT, THIRD PARTY NOTIFICATION
0937-0194 NATIONAL SURVEY OF WORKSITE HEALTH PROMOTION ACTIVITIES
0937-0192 EVALUATING EFFECTIVE COMMUNICATION STRATEGIES FOR HEALTH INFORMATION TO HIGH RISK YOUTH OUT OF SCHOOL
0937-0191 Application Packets for Real Property for Public Health Purposes
0937-0190 AIDS COST AND SERVICE UTILIZATION SURVEY
0937-0189 PHS Supplements to Application for Federal Assistance -- SF-424
0937-0188 GRANT APPLICATIONS FOR MINORITY AIDS EDUCATION/PREVENTION PROJECTS
0937-0187 1987 NATIONAL MEDICAL EXPENDITURE SURVEY (REVISION HEALTH INSURANCE PLANS SURVEY)
0937-0186 STUDY OF RESEARCHERS FOCUSING ON RARE DISEASES AND ON COMMON DISEASES: BARRIERS TO ACHIEVING RESEARCH OBJECTIVES
0937-0185 STUDY OF PHYSICIANS' EXPERIENCES IN TREATING PATIENTS WITH RARE DISEASES
0937-0184 STUDY OF PATIENTS WITH RARE AND COMMON DISEASES: EXPERIENCES WITH RESEARCH, DIAGNOSIS AND TREATMENTS
0937-0183 1987 NATIONAL MEDICAL EXPENDITURE SURVEY (ROUND 5 OF THE HOUSEHOLD SURVEY)
0937-0182 ASSESSMENT OF THE DEVELOPMENT AND IMPLEMENTATION OF STATE AIDS CONTACT NOTIFICATION PROGRAMS
0937-0181 FINANCIAL MANAGEMENT AND MEDICAL RECORD SYSTEMS - 42 CFR 59.9
0937-0180 ASSURANCE OF COMPLIANCE WITH PROHIBITION ON ABORTION, 42 CFR 59.7
0937-0179 1987 NATIONAL MEDICAL EXPENDITURE SURVEY (ROUND 4 OF HOUSEHOLD SURVEY AND SURVEY OF AMERICAN INDIANS AND ALASKA NATIVES, PHASE III OF INSTITUTIONAL POPULATION COMPONENT)
0937-0178 THIRD NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY (NHANES III) PILOT TESTS
0937-0176 1988 NATIONAL MATERNAL AND INFANT HEALTH SURVEY AND 1987 PRETEST
0937-0175 1987 AUTOMATED NATIONAL HEALTH INTERVIEW SURVEY (NHIS) FEASIBILITY STUDY
0937-0174 1988 NATIONAL HEALTH INTERVIEW SURVEY (PRETEST)
0937-0173 1987 NATIONAL WORK INJURY FOLLOWBACK SURVEY (WIFS)
0937-0171 NATIONAL NURSING HOME SURVEY FOLLOWUP
0937-0170 LABORATORY RESEARCH ON RESPONSE ERROR ON HEALTH SURVEY QUESTIONS
0937-0169 NCHS LABORATORY-BASED QUESTIONNAIRE RESEARCH
0937-0168 FEDERAL REGISTER NOTICE -- AIDS VACCINE DEVELOPMENT: PRIVATE SECTOR/GOVERNMENT COLLABORATIVE EFFORTS
0937-0167 GRANT APPLICATIONS FOR MINORITY COMMUNITY HEALTH COALITION DEMONSTRATION PROJECTS
0937-0166 42 C.F.R. Subpart B: Sterilization of Persons in Federally Assisted Family Planning Projects
0937-0164 EVALUATION OF COVERAGE OF HEALTH FACILITIES IN THE NATIONAL MASTER FACILITY INVENTORY
0937-0163 1987 NATIONAL MEDICAL EXPENDITURE SURVEY - (ROUNDS 2 AND 3 OF HOUSEHOLD SURVEY AND SURVEY OF AMERICAN INDIANS AND ALASKA NATIVES, PHASE II OF INSTIT. POPULATION COMPONENT)
0937-0162 NATIONAL CHILDREN AND YOUTH FITNESS STUDY II
0937-0161 1987 NATIONAL HEALTH INTERVIEW SURVEY (PRETEST)
0937-0160 SURVEY TO ASSESS THE PREVALENCE, ATTITUDES, KNOWLEDGE, AND BELIEFS ABOUT SMOKING BEHAVIOR AMONG THE ADULT POPULATION
0937-0159 LINKED TELEPHONE SURVEY STUDY
0937-0158 LIST OF INGREDIENTS ADDED TO TOBACCO IN THE MANUFACTURER OF CIGARETTES
0937-0157 SMOKING SUPPLEMENT TO THE SEPTEMBER 1985 CURRENT POPULATION SURVEY
0937-0155 ADDENDUM TO FINANCIAL STATUS REPORT
0937-0153 1987 NATIONAL MEDICAL EXPENDITURE SURVEY (PRETEST OF MEDICAL PROVIDER SURVEY, PATIENT-IDENTIFIED PHYSICIANS SURVEY, AND HEALTH INSURANCE PLANS SURVEY)
0937-0149 NATIONAL SURVEY OF WORKSITE HEALTH PROMOTION PROGRAM
0937-0148 PRESIDENT'S COUNCIL ON PHYSICAL FITNESS AND SPORTS SCHOOL POPULATION SURVEY
0937-0146 EVALUATION OF THE PRODUCTS AND SERVICES OF PHS CLEARINGHOUSES
0937-0145 1986 NATIONAL HEALTH INTERVIEW SURVEY (FIRST PRETEST)
0937-0144 1986 NATIONAL MORTALITY FOLLOWBACK SURVEY
0937-0141 1985 NATIONAL AMBULATORY MEDICAL CARE SURVEY
0937-0140 LABORATORY-BASED RESEARCH ON THE COGNITIVE ASPECTS OF SURVEY METHODOLOGY: REPORTING CHRONIC CONDITIONS IN THE NATIONAL HEALTH INTERVIEW SURVEY
0937-0139 LONGITUDINAL STUDY ON AGING (LSOA)
0937-0137 LINKED TELEPHONE SURVEY STUDY
0937-0136 SITE VISITS TO STATE AGENCIES FOR AN EVALUATION OF THE NATIONAL MASTER FACILITY INVENTORY (NMFI)
0937-0135 EVALUATION OF DATA DISSEMINATION AND DATA USE
0937-0134 NHANES I EPIDEMIOLOGIC FOLLOWUP STUDY: CONTINUED FOLLOWUP
0937-0133 EVALUATION OF NATIONAL CAUSE-OF-DEATH DATA - PILOT STUDY
0937-0132 EVALUATION OF THE NCHS POPULATION-BASED SURVEYS REPRODUCTIVE HEALTH SURVEY
0937-0131 1985 NATIONAL HEALTH INTERVIEW SURVEY (FIRST PRETEST)
0937-0130 EMERGENCY PREPAREDNESS STORAGE LOCATION: PRE-POSITIONED MEDICAL SUPPLIES AND EQUIPMENT
0937-0129 1984 NATIONAL HEALTH INTERVIEW SURVEY (NHIS) RANDOM DIGIT DIALING (RDD) FEASIBILITY STUDY
0937-0128 NATIONAL AMBULATORY MEDICAL CARE SURVEY
0937-0127 SURVEY OF THE ANTECEDENTS, MEDIATORS, AND HEALTH CONSEQUENCES OF STRESS
0937-0126 NCHS PUBLICATIONS SURVEY
0937-0125 EVALUATION OF THE NCHS POPULATION-BASED SURVEYS - CONTACT PERSON
0937-0124 NCHS APPLICATION FOR TECHNICAL ASSISTANCE - TRAINING FORM
0937-0123 INVOLUNTARY CHILD AND SPOUSAL SUPPORT ALLOTMENTS, PUBLIC HEALTH SERVICE COMMISSIONED PERSONNEL
0937-0121 EVALUATION OF THE NCHS POPULATION-BASED SURVEYS - MEDICAL EXPENDITURE SURVEY
0937-0120 PHS CONTRACTORS PROFILE SYSTEM
0937-0118 EVALUATION OF THE DATA COLLECTION POLICIES OF THE NATIONAL AMBULATORY MEDICAL CARE SURVEY
0937-0117 GRANT APPLICATIONS FOR RESEARCH PROJECTS ON ADOLESCENT PREGNANCY AND FAMILY LIFE
0937-0116 GRANT APPLICATIONS FOR DEMONSTRATION PROJECTS ON ADOLESCENT PREGNANCY AND FAMILY LIFE
0937-0115 1985 NATIONAL NURSING HOME SURVEY
0937-0114 EVALUATION OF THE DATA PROVIDED FOR THE NATIONAL VITAL STATISTICS PROGRAM
0937-0113 NATIONAL CHILDREN AND YOUTH FITNESS STUDY
0937-0112 NATIONAL HEALTH INTERVIEW SURVEY (NHIS) (1984 LST PRETEST QUESTIONNAIRE)
0937-0111 PARENTAL NOTIFICATION AND RECORDKEEPING REQUIREMENTS APPLICABLE TO PROJECTS FOR FAMILY PLANNING SERVICES UNDER TITLE X OF THE PHS ACT
0937-0110 1983/1984 AGENCY REPORTING SYSTEM SURVEY
0937-0109 EVALUATION OF DATA COLLECTION POLICIES OF THE NATIONAL AMBULATORY MEDICAL CARE SURVEY
0937-0108 NATIONAL REGISTRY OF HMO FINANCING NEEDS
0937-0107 FINANCIAL STATUS REPORT
0937-0106 SURVEY OF EMPLOYER EXPERIENCE WITH HEALTH MAINTENANCE ORGANIZATIONS (HMO'S)
0937-0104 NATIONAL SURVEY OF FAMILY GROWTH, CYCLE IV
0937-0103 HMO QUALIFICATION AND LOAN/LOAN GUARANTEE FORM
0937-0102 DIRECTORY OF ON-GOING RESEARCH IN SMOKING AND HEALTH
0937-0101 1983 NATIONAL HEALTH INTERVIEW SURVEY ALCOHOL/HEALTH PRACTICES SUPPLEMENT TELEPHONE PRETEST
0937-0099 TENTH WAVE SURVEY OF SOUTHEAST ASIAN REFUGEES: (A) SHORT FORM, (B) LONG FORM
0937-0098 PILOT STUDY OF THE 1981-1982 VISUAL ACUITY IMPAIRMENT SUPPLEMENT (TO THE NATIONAL HEALTH INTERVIEW SURVEY)
0937-0096 1982 NATIONAL HEALTH INTERVIEW SURVEY (NHIS)
0937-0095 Application to the Board of Correction of Public Health Service Commissioned Corps Records
0937-0093 REQUIREMENT TO DISCLOSE HMO FINANCIAL INFORMATION TO MEMBERS
0937-0088 APPLICATION AND RELATED FORMS FOR THE OPERATION OF THE NATIONAL DEATH INDEX
0937-0086 EVALUATION OF NATIONAL HEALTH PROMOTION MEDIA CAMPAIGN
0937-0085 FACTORS CONTRIBUTING TO PUBLIC HEALTH SERVICE NURSE RETENTION AND TURNOVER
0937-0082 NCHS DATA TAPE QUESTIONNAIRE
0937-0081 FIELD TEST OF A LONG TERM CARE DATA SET IN SELECTED SITES
0937-0079 SURVEY OF UNITED MINEWORKERS HEALTH AND RETIREMENT FUNDS BENEFICIARIES
0937-0078 HISPANIC HEALTH AND NUTRITION EXAMINATION SURVEY (HHANES)
0937-0077 EVALUATION OF APPLICATION OF SEVERAL EXISTING NATIONAL DATA COLLECTION METHODOLOGIES TO SELECTED SMALL GEOGRAPHIC AREAS
0937-0076 HEALTH ACTION SURVEY
0937-0075 ORGANIZATIONAL STRUCTURE OF HMO'S
0937-0074 PRETEST OF THE 1981 HEALTH INTERVIEW SURVEY QUESTIONNAIRE
0937-0070 WISCONSIN HEALTH STATUS SURVEY DEMONSTRATION PROGRAM
0937-0067 MANAGEMENT TRAINING NEEDS ASSESSMENT SURVEY
0937-0066 NATIONAL AMBULATORY MEDICAL CARE SURVEY - 1980 COMPLEMENT SURVEY
0937-0064 EVALUATION OF PARTICIPATION IN NATIONAL UTILIZATION SURVEYS
0937-0063 SURVEY OF SERVICES PROVIDED BY ADOLESCENT PREGNANCY PROGRAMS
0937-0049 FAMILY GROWTH-CYCLE III: PILOT STUDY
0937-0045 1980 NATIONAL NATALITY SURVEY; 1980 NATIONAL FETAL MORTALITY SURVEY
0937-0038 NATIONAL SURVEY OF FAMILY GROWTH - CYCLE III: PRETEST
0937-0037 DEMONSTRATION OF EFFICIENCY PAYMENT SYSTEM FOR NURSING HOMES
0937-0036 NATIONAL LONGITUDINAL HEALTH SURVEY
0937-0035 EVALUATION OF WORKSHOPS--OFFICE OF ADOLESCENT PREGNANCY PROGRAM
0937-0034 STATUS ASSESSMENT OF INACTIVE RESERVE OFFICER AVAILA- BILITY
0937-0033 AGENCY REPORTING SYSTEM FOR UPDATING THE NATIONAL INVENTORY OF FAMILY PLANNING SERVICE SITES
0937-0032 MINIMUM DATA SET FOR THE HEALTH FACILITIES COMPONENT OF THE CHSS
0937-0030 NATIONAL MEDICAL CARE UTILIZATION AND EXPENDITURE SURVEY
0937-0029 PUBLIC HEALTH SERVICE STERILIZATION RECORD
0937-0028 NATIONAL HMO CENSUS
0937-0027 MASTER FACILITY INVENTORY--COMPLEMENT SURVEY
0937-0026 NATIONAL SURVEY OF PERSONAL HEALTH PRACTICES AND HEALTH CONSEQUENCES
0937-0025 Reference Request for Applicants to the U.S. Public Health Service Commissioned Corps
0937-0024 REPORT OF MEDICAL HISTORY
0937-0023 APPLICATION FOR APPOINTMENT AS A COMMISSIONED OFFICER IN THE UNITED STATES PUBLIC HEALTH SERVICE
0937-0022 HEALTH MAINTENANCE ORGANIZATION NATIONAL DATA REPORTING REQUIREMENTS
0937-0021 1988 NATIONAL HEALTH INTERVIEW SURVEY
0937-0017 NATIONAL AMBULATORY MEDICAL CARE SURVEY (1980-81)
0937-0016 APPLIED STATISTICS TRAINING INSTITUTE APPLICATION
0937-0013 OHMO PROGRESS REPORT ON PLANNING GRANTS
0937-0012 PROGRESS REPORT - HMO FEASIBILITY ACTIVITIES
0937-0011 SUPPLEMENTS TO FINANCIAL STATUS REPORT
0937-0009 STATE PLAN CERTIFICATION FORM AND STATE HEALTH PLAN BUDGET
0937-0007 MONTHLY VITAL STATISTICS REPORT FORMS
0937-0006 1982 NATIONAL MASTER FACILITY INVENTORY SURVEY AND COMPLEMENT SURVEY
0937-0005 CLINIC VISIT RECORD FOR FAMILY PLANNING SERVICES
0937-0004 NATIONAL HOSPITAL DISCHARGE SURVEY
0937-0002 MONTHLY MARRIAGE & DIVORCE STATISTICAL REPORT FORMS/ REPORT ON MARRIAGES, DIVORCES & ANNULMENTS
0937-0001 ANNUAL MARRIAGE AND DIVORCE STATISTICAL REPORT FORMS

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