Departmental Management

HHSDM

Federal Forms

Forms
OMB NumberTitle
0990-0482 National Hypertension Control Initiative
0990-0481 For HHS/OASH Consultation Process, Institutional Review Board (IRB) Records
0990-0480 Components Study of REAL Essentials
0990-0479 Family Planning Annual Report 2.0
0990-0478 Unified Hospital Data Surveillance System (U.S. Healthcare COVID-19 Collection)
0990-0477 Office for Human Research Protections Incident Report Form
0990-0476 ASPA COVID-19 Public Education Campaign Market Research
0990-0475 ASPA COVID-19 Public Education Campaign Evaluation Surveys
0990-0474 SUD Placement Criteria Survey
0990-0473 Subpart C Research Certification Form
0990-0472 Evaluation of Pregnancy Prevention Program Replications for High Risk and Hard to Reach Youth
0990-0471 Evaluation of the Kidney Innovation Accelerator (KidneyX)
0990-0470 HHS Office on Women's Health State-Level Paid Family Leave Policy Project
0990-0469 Cross-site Study Data for Improving Implementation Evaluation among Office of Adolescent Health (OAH) Teen Pregnancy Prevention (TPP) Grantees to inform National Implementations (IMAGIN)
0990-0468 Cohort 3 FY2018 Teen Pregnancy Prevention (TPP) Program Performance Measures
0990-0467 WOMEN’S HEALTH CAMPUS SEXUAL ASSAULT POLICY AND PREVENTION INITIATIVE CROSS-SITE EVALUATION
0990-0466 Fraud and Abuse: Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price
0990-0465 Evaluation of the Assisted Outpatient Treatment Grant Program for Individuals with Serious Mental Illness
0990-0464 Trafficking Victim Assistance Program Social Network Analysis--Network Survey
0990-0463 I Can Do It, You Can Do It
0990-0462 Assessment of Women’s Behavioral Health in Eastern Montana and Western North Dakota
0990-0461 Evaluation of the Certified Community Behavioral Health Clinic Demonstration
0990-0460 The Pregnancy Assistance Fund (PAF) Performance, FY2017-FY2019, revised for cohort 5
0990-0459 Fast Track Generic Clearance for the Collection of Routine Customer Feedback - HHS Communication
0990-0458 Domestic Violence Housing First Demonstration Evaluation
0990-0457 National Tissue Recovery through Utilization Survey (NTRUS)
0990-0456 Evaluating Supporting Nursing Moms at Work
0990-0455 OWH Evaluation of Women's Health Leadership Institute Program
0990-0454 OWH IPV Provider Network Cross-Site Evaluation
0990-0453 Evaluation of the Second Decade Project Community Planning Guide
0990-0452 Federal Evaluation of Making Proud Choices! (MPC!)
0990-0451 Teen Pregnancy Prevention Tier 1B Design and Implementation Study
0990-0450 Sustainability Study of Federally-Funded programs Designed to Prevent or Delay Teen Pregnancy
0990-0449 Million Hearts Social Network Analysis: Network Survey--
0990-0448 Surgeon General’s Pledge to Stem the Opioid Epidemic
0990-0447 Faith-Based or Religious Organizations and Providing for Equal Treatment of Department of Health and Human Services Program Participants"
0990-0445 Examining Consumer and Producer Responses to Restaurant Menu Labeling Requirements
0990-0444 Privacy and Security Capacity Assessment of the Title X Network
0990-0443 Evaluation of the Office on Women's Health (OWH) Coalition for a Healthier Community (CHC) Initiative
0990-0442 Title X Substainability Assessment Tool For Grantees and Service Sites
0990-0441 State Minority Health Entity Survey
0990-0440 Evaluation of the National Training on Trauma-Informed care (TIC)
0990-0439 Midwest HIV Prevention and Pregnancy Planning Initiative (MHPPPI)
0990-0438 Teen Pregnancy Prevention (TPP) Performance Measures for FY2020
0990-0437 Healthy People User Study
0990-0436 HHSAR 311.7300
0990-0434 HHSAR 311.7102 and 311.7202(b), Meetings, Conferences, and Seminars - Public Accommodations and Commercial Facilities - Funding and Sponsorship
0990-0433 HHSAR 337.103(d)(4), Indian Child Protection and Family Violence Act
0990-0432 HHSAR 370.401, Acquisitions Involving the Use of Laboratory Animals
0990-0431 HHSAR 370.301, Acquisitions Involving Human Subjects
0990-0430 HHSAR 337.103(d)(3), Crime Control Act—Requirement for Background Checks
0990-0429 National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care: Evaluation of Awareness, Adoption, and Implementation
0990-0428 Pregnancy Assistance Fund (PAF) Implementation Study
0990-0427 Tissue and Organ Donor Epidemiology Study (TODES)
0990-0426 2.0 Data Element Survey- Title X Family Planning Annual Report (FPAR)
0990-0425 Cost Study of Evidence-Based Teen Pregnancy Prevention Programs
0990-0424 Pregnancy Assistance Fund Feasibility And Design Study(Positive Adolescent Futures)
0990-0423 Title X Family Planning Outreach and Enrollment Data Collection
0990-0422 Educating and Training of Healthcare Violence Against Women
0990-0421 ASPE Generic Clearance for the Collection of Qualitative Research and Assessment
0990-0420 Support And Services at Home (SASH) Participant Survey
0990-0419 Acquisition Regulation Clause Patent rights and Rights in Data
0990-0418 Pre-Test of Instruments of Psychosocial Care for the Treatment of Adults with PTSD
0990-0417 Survey on Long-Term Care Awareness and Planning
0990-0416 Pregnancy Assistance Fund (PAF) Performance Measures Collection
0990-0415 Survey of Physician Time Use Patterns under the Medicare Fee Schedule
0990-0414 WHAM: Women Health and Mindfulness Program
0990-0413 Living Healthier Living Longer Program
0990-0412 Doing It For Ourselves (DIFO) Program
0990-0411 Out, Proud and Healthy Fitness Project
0990-0410 MOVE: Making Our Vitality Evident
0990-0409 Ryan White/AIDS Program Modeling Study
0990-0408 Evaluation of Implementation of the Viral Hepatitis Action Plan
0990-0407 OS Think Cultural Health
0990-0406 Evaluation of the National Partnership for Action to End Health Disparities
0990-0405 TPP Replication Study Follow Up Data Collection
0990-0404 Children's Health Insurance Program Reauthorization Act (CHIPRA) 10-State Evaluation, Telephone Interviews with State CHIP Program Administrators
0990-0403 Survey of Primary Care Physicians on Oral Health
0990-0402 Patient Centered Care Collaboration to Improve Minority Health Project
0990-0401 Campaign Within the Latino Community on Right to Non-Discrimination in Certain Health and Human Service Programs
0990-0400 CHIPRA-Children's Health Insurance Program Reauthorization Act of 2009 -ELE
0990-0399 Evaluation of the Effectiveness of an Educational Interactive Video on Research Integrity
0990-0398 Consumer Survey of Attitudes Toward the Privacy and Security Aspects of Electronic Health Records and Electronic Health Information Exchange
0990-0397 Teen Pregnancy Prevention Replication Evaluation: Replication Study
0990-0396 Multisite Evaluation of the In Community Spirit Program - Prevention of HIV/AIDS for Native/American Indian and Alaska Native Women Living in Rural and Frontier Indian Country
0990-0395 Cross-site Evaluation of the Minority Serving Institutions' HIV/AIDS Demonstration Initiative and Capacity Building Project
0990-0394 Teen Pregnancy Prevention Replication Evaluation: Baseline Data
0990-0393 Evaluation of the Consumer Education Campaign "Make the Call-Don't Miss a Beat"
0990-0392 ACYF Pregnancy Prevention Performance Measure Collection
0990-0391 The Hospital Preparedness Program
0990-0390 Generic: Challenge and Competition solicitations
0990-0389 Outcome Evaluation of "Teenage Pregnancy Prevention:Intergrating Services, Programs, and Strategies through Community-Wide Intitatives"
0990-0388 Baseline Let's Move! Cities, Towns and Counties Participant Survey
0990-0387 Wellness Program Study
0990-0386 2012 Healthy New Year Video Contest
0990-0385 Multi-Component Evaluation of the Bodyworks Program
0990-0384 CHIPRA_ Children Health Insurance
0990-0383 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (HITRC)
0990-0382 Evaluation of Pregnancy Prevention Approaches - First Follow-up
0990-0381 Comparative Effectiveness Research: Portfolio
0990-0380 Evaluation of the IT Professionals in Health Care Workforce Program: University-Based Training
0990-0379 Fast Track Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
0990-0378 Permanent Certification Program for Health Information Technology
0990-0377 Request to Solicit Public Input to Nominate Non-federal Health and Health Care Data Sets and Applications For Listing on Healthdata.gov
0990-0376 Comprehensive Communication Campaign for HITECH ACT
0990-0375 Evaluation of Pregnancy Prevention Approaches:Implementation Study Data Collection
0990-0374 ARRA Section 3013 State Health Information Exchange Cooperative Agreement Program: State Plans
0990-0373 Prevention and Wellness-Leveraging National Organizations
0990-0372 Evaluation of the IT Professionals in Health Care
0990-0371 Evaluation of SAMHSA Primary Care Behavioral Health Integration Grant Program
0990-0370 ARRA Section 3013 State Health Information Exchange Cooperative Agreement Program: Performance Measures and Program Progress Report
0990-0369 Regional Extension Center Cooperative Agreement Program (CRM Tool)
0990-0368 An Assessment of the Sustainability and Impact of Community Coalitions Once Federal Funding Has Expired
0990-0367 ONC Temporary Certification Program's Application, Reporting and Records Requirements
0990-0366 Child Maltreatment
0990-0365 Study of the Costs Associated with Community Activities under the Communities Putting Prevention to Work CPPW) Initiative
0990-0364 Whistleblower Study
0990-0363 Healthy Living Innovation Awards
0990-0362 Evaluation of the Parents Speak Up National Campaign: Focus Groups with Adolescents
0990-0361 Patient Perpective of Delivery of Health Care Through the use of an Electronic Health Record Survey
0990-0360 Girls at Greater Risk for Juvenile Delinquency and HIV Prevention Program
0990-0359 Attitudes toward Electronic Health Information Exchange and Associated Privacy and Security Aspects
0990-0358 Application for ONC-Authorized Testing & Certification Bodies (ATCB)
0990-0357 Research Mentoring Dyad Study
0990-0356 Multidisciplinary Health Care Models for Women Sustainability Assessment Survey
0990-0355 Evaluate the Advancing Systems Improvements to Support Targets for Healthy People 2010 (ASIST2010) Program
0990-0354 Parent Speak Up National Campaign: Website
0990-0353 ARRA Section 3016 Information Technology Professionals in Health Care: Competency Examination for Individuals Completing Non-Degree Training
0990-0352 Section 3016 Information Technology Professionals in Health Care: Program of Assistance for University-Based Training
0990-0351 Health Information Technology Research Centers of Excellence (TRCE)
0990-0350 Community College Consortia Program to Education Information Technology Professionals in Health Care
0990-0349 Information Technology Professionals in Health Care: Curriculum Development Centers
0990-0348 Beacon Community Cooperative Agreement Program
0990-0347 Facts for Consumers About Health
0990-0346 HITECH Act Breach Notification
0990-0345 Evaluation of the Parents Speak Up National Campaign: National Media Tracking Surveys
0990-0344 HAvBed Assessment for to Prepare for Public Health Emergencies
0990-0343 Section 3012 Health Information Technology Extension Program: Full Application
0990-0342 Section 3013 State Health Information Exchange Cooperative Agreement Program: Full Application
0990-0341 ASPR Assessment of Mechanical Ventilators in US Acute Care Hospitals
0990-0340 ARRA Section 3012 Supporting Statement for State Health Information Exchange Cooperative Agreement Program
0990-0339 ARRA Section 3013 Supporting Statement for State Health Information Exchange Cooperative Agreement Program
0990-0338 2009 Flu Prevention Public Service Announcement Contest Form
0990-0337 The National Bone Health Campaign Pilot Site Project
0990-0336 Evaluating Institutions Research Misconduct Education Efforts
0990-0335 Trends in U.S. Public's Awareness of Racial and Ethnic Heatlh Disparities (1999- 2008)
0990-0334 Evaluation of HIV Prevention Program for Women
0990-0333 Partnership for Long Term Care Insurer Reporting Requirements
0990-0332 Evaluation of the Afghanistan Health Initiative Project
0990-0331 Evaluation of The Marriage and Family Strengthening Grants
0990-0330 OMHA Annual Appellant Climate Survey
0990-0329 Healthy People User Survey
0990-0328 Evauation of the I Can do It, You Can Do It Health Promotion Program fo Children and Youth with Disabilities
0990-0327 Training Ph.D.s Faculty Views on Their Role and Their Institution's Role to Promote the Development of Responsible Researchers
0990-0326 Hospital Preparedness Program Data Collection
0990-0325 Evaluation of the Parents Speak Up National Campaign: Youth Survey
0990-0324 Report of Medical History/Examination
0990-0323 Medical Countermeasures.Gov
0990-0322 Safe Harbor for Federally Qualified Health Centers Arrangements
0990-0321 HHS Website Usability
0990-0320 Homelessness Data for Health and Human Services Mainstream Programs
0990-0319 Evaluation of Office on Women's Health Publications
0990-0318 The Role of Faith-based and Community Organizations in Post-Hurricane Human Services Relief Efforts
0990-0317 HHS Supplemental Form to the SF-424 (HHS 5161-1)
0990-0316 The National Evaluation of the Rural/Frontier Women's Health Coordinator Center
0990-0315 Understanding Barriers and Successful Strategies for Faith-Based Organizations in Accessing Grants
0990-0314 Evaluation of Parents Speak Up National Campaign: Focus Group
0990-0313 National Blood Collection and Utilization Survey
0990-0312 EHR Adoption in Ambulatory Physician Care Practices
0990-0311 Evaluation of the National Abstinence Media Campaign
0990-0310 The Heart Truth Evaluation of Professional Materials
0990-0309 Oklahoma Marriage Initiative Process Evaluation
0990-0308 The Effect of Reducing Falls on Acute and Long -Term Care Expenses
0990-0307 Evaluation of OHRP Educational Activities
0990-0306 Bodyworks Toolkit Evaluation Survey
0990-0305 Research Integrity Officer (RIO) Study
0990-0304 National Outcomes Performance Assessment of the Collaborative Initiative to Help End Chronic Homelessness
0990-0303 National Women's Health Week (NWHW) Survey
0990-0302 Medical Reserve Corps (MARC) Unit Profile and Reports
0990-0300 Adolescent Family Life Prevention Demonstration Project End of Year Template
0990-0299 Adolescent Family Life Care Demonstration Project End of Year Care Template (EOYC)
0990-0297 National Community Centers of Excellence in Women's Health and National Centers of Excellence in Women's Health Joint Project Evaluation/Professional/Professional Surveys
0990-0296 National Community Centers of Excellence in Women's Health and National Centers of Excellence in Women's Health Joint Project Evaluation/Participant Survey
0990-0295 Survey of Frontline Supervisors of Direct Service Workers Participating in the Better Jobs Better Care Demonstration
0990-0294 Standards for Privacy of Individually Identifiable Health Information and Supporting Regulations at 45 CFR Parts 160 and 164
0990-0292 Burn Bed Enumeration
0990-0291 Adolescent Family Life Program: Prevention Demonstration Projects
0990-0290 Adolescent Family Life Care Program Core Evaluation
0990-0289 Evaluation of HIV Prevention Programs for Women
0990-0288 National Heart, Lung, and Blood Institute (NHLBI) The Heart Truth Professional Education Campaign Provider Pretest/Posttest
0990-0287 HHS Research Misconduct Final Rule
0990-0286 Homeless, Veterans, Women, Healthcare
0990-0285 Office for Human Research Protections, Fellowship Program
0990-0282 Wave 4 Survey of Youth for the Federal Evaluation of Initiatives Funded Under SEction 510 of the Maternal and Child Health Block Grant
0990-0281 Prevention Communication Formative Research
0990-0280 Reporting Suspected Research Misconduct in Biomedical and Behavioral Research
0990-0279 Institutional Review Board Registration Form
0990-0278 Federalwide Assurance (FWA)
0990-0277 Family Planning Survey: Tixle X-funded sites that also provide abortion
0990-0276 Assessment Study of the Uses of Healthier US and Healthy People 2010
0990-0275 Implementation of an Internet & Paper-Based Uniform Data Set for OMH-funded Activities
0990-0274 Survey of State and Local Contracting Officials on Contracting for Social Services Under Charitable Choices
0990-0273 Evaluation of the Office of Minority Health Resource Center
0990-0272 National Women's Health Information Center (NWHIC) Customer Satisfaction Questionnaire
0990-0271 DataCollection for the Identification ofComparisonGroups for the National Com. Ctrs of Excellencein Women's Health (CCOE) Program
0990-0270 Survey of SCHIP State Administrators
0990-0269 Complaint Forms for Discrimination; Health Information Privacy Complaints
0990-0268 Service Use and Transition of Private Long-term Care Insurance
0990-0267 Study of Fathers' Involvement in Permanency Planning and Child Welfare Casework
0990-0266 Global Health Public Opinion Survey
0990-0265 Assessment of State Laws, Regulations, and Practice Affecting the Collection and Reporting of Racial/Ethnic Health Data
0990-0264 State Studies on TANF Caseload
0990-0263 Protection of Human Subjects Assurance Identification/IRB Certification/Declaration of Exemption
0990-0262 Survey of Research Integrity Measures Utilized in Biomedical Research Laboratories
0990-0260 Protection of Human Subjects: Common Rule (56 FR 28001)
0990-0258 A Study of Stroke Post-Acute Care Outcomes
0990-0257 Wave Three Survey of Youth for the Evaluation of Initiatives Funded Under Section 510 of the Maternal & Child Health Block Grant
0990-0256 Survey of SCHIP Enrollees and Disenrollees for the Congressionally Mandated Evaluation of the State Children's Health Insurance Program
0990-0255 National Study of Culturally and Linguistically Appropriate Services in Managed Care Organization
0990-0253 National Study of Child Protective Services Systems and Reform Efforts
0990-0250 National Centers of Excellence in Women's Health Program Supplemental Quantiative Community Survey
0990-0248 Organizing an Institutional Investigation Assistance Program: A Feasibility Study
0990-0247 State Children's Health Insurance Program Focus Group Study
0990-0245 ORI Educational Program: A Needs Assessment
0990-0244 National Centers of Excellence in Women's Health Program Quantitative Evaluation Survey
0990-0243 OCR Pre-granted Automation Project
0990-0242 BodyWise Eating Disorders Initiative - Evaluation
0990-0241 Analysis of Guidelines for the Conduct of Research Adopted by Medical Schools or their Components
0990-0240 Survey of Grant Recipients
0990-0239 Empowerment Zone and Enterprise Community Health Improvement Capacity Survey
0990-0238 Patient Follow-up Survey for the Multi-site Evaluation of the Welfare-to-Work Grants Program
0990-0237 First Follow-up Survey of Youth - Federal Evaluation of Initiatives Funded Under Section 510 of the Maternal and Child Health Block Grant Program
0990-0236 Financial Summary of Obligation and Expenditure of Block Grant Funds (45 CFR 96.30)
0990-0235 Research on Employment Supports for People with Disabilities
0990-0234 Survey of Opinions of Principal Investigators on Managing a Biomedical Laboratory
0990-0233 Baseline Survey of Youth; Federal Evaluation of Initiatives Funded under Section 510 of the Maternal and Child Health Block Grant Program
0990-0232 Cash and Counseling Demonstration--Additional Survey Instruments
0990-0231 Second Mail Survey for the Multi-Site Evaluation of the Welfare-to-Work Grants Program
0990-0230 Site Visit Protocols for the Multi-site Evaluation of the Welfare-to-Work Grants Program
0990-0229 Office of Minority Health Resource Center Evaluation Survey
0990-0228 Baseline Data Collection Forms for the Multi-Site Evaluation
0990-0227 All-Grantee Mail Survey and 35 Site Visits for the Multi-Site Evaluation of the Welfare-to-Work Grants Program
0990-0226 Study of Medicare Home Health Practice Variations
0990-0225 Study of Frail Elders in Medicare Managed Care
0990-0224 Cost Allocation Determinations under the Agriculture Research Act
0990-0223 Evaluation of the Cash and Counseling Demonstration
0990-0222 Analysis of Employer Group Long-Term Care Insurance
0990-0221 Family Planning Annual Report: Forms and Instructions
0990-0220 Voluntary Industry Partner Surveys to Implement E.O. 12862
0990-0219 Study of the Implementation of OMH's Bilingual/Bicultural Service Demonstration Grants
0990-0218 Revised OIG Exclusion Activities Resulting from Public Law 104-191 -- RW CFR 1002.3
0990-0217 National Study of Assisted Living for the Frail Elderly
0990-0216 Information Collection Requirements Contained in 42 CFR Part Obligations
0990-0215 A Comparison of Formal and Informal Caregiving Among Disabled Elders With and Without Long-Term Care Insurance
0990-0213 Information Collection Requirements Contained in 42 CFR Part 1008, Issuance of Advisory Opinions by the OIG and Preliminary Questions
0990-0212 Five-Year Follow-Up Survey for the Jobs Welfare-to-Work
0990-0211 Alternative Models of Personal Assistance Services
0990-0210 The Evaluation of Family Preservation and Reunification Services
0990-0209 1995 Short-term, General, and Other Special Hospital Civil Rights Compliance Report and Hill-Burton Community Service Assurance Report for Triennial V
0990-0208 Applicant Background Survey
0990-0207 DHHS/ACF TEENAGE PARENT DEMONSTRATION EVALUATION, SECOND FOLLOW-UP DATA COLLECTION INSTRUMENTS
0990-0206 PHYSICIAN SURVEY REGARDING 1992 NEW VISIT CODES, MEDICARE
0990-0205 QUESTIONNAIRE TO CONDUCT SURVEY OF MEDICARE BENEFICIARY UNDERSTANDING OF THE EXPLANATION OF MEDICAL BENEFITS
0990-0203 JOBS EVALUATION, 2-YEAR FOLLOWUP
0990-0202 ANALYSIS AND COMPARISON OF STATE BOARD AND CARE REGULATIONS AND THEIR EFFECT ON THE QUALITY OF CARE IN BOARD AND CARE HOMES
0990-0200 QUESTIONNAIRE TO CONDUCT A ONE-TIME "SAFE HARBOR REGULATIONS SURVEY"
0990-0198 UNIFORM ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND COOPERATIVE AGREEMENTS TO STATE AND LOCAL GOVERNMENTS
0990-0196 JOBS EVALUATION - BASELINE DATA COLLECTION ACTIVITIES
0990-0194 SURVEY OF PHYSICIANS INTERACTIONS WITH PHARMACEUTICAL MANUFACTURERS
0990-0193 STATE POLICIES, PROCEDURES AND EXPERIENCES IN PROVIDING CHILD CARE, TRANSITIONAL CHILD CARE, AND CHILD CARE-RELATED TRANSPORTATION SERVICES TO AFDC JOBS PARTICIPANTS
0990-0191 PERSPECTIVES QUESTIONNAIRE - IV-A
0990-0190 SURVEY OF PORTABLE X-RAY SUPPLIERS
0990-0189 RESEARCH STUDY TO TEST PROCEDURES TO SCREEN FOR BOARD AND CARE HOMES USING 1988 CENSUS DRESS REHEARSAL DATA
0990-0187 SURVEY OF PHYSICIAN PRACTICES
0990-0186 THE APPROPRIATE USE OF TECHNOLOGY: PILOT STUDY
0990-0185 TEENAGE PARENT DEMONSTRATION 24-MONTH FOLLOW-UP SURVEY
0990-0184 REVIEW TO IDENTIFY MEDICARE SECONDARY PAYER SITUATIONS
0990-0182 SHORT-TERM EVALUATION OF STATE AND LOCAL GENERAL ASSISTANCE PROGRAMS
0990-0181 QUESTIONNAIRE TO CONDUCT PERIODIC NATIONAL STATE-SPECIFIC MEDICARE BENEFICIARY SURVEYS
0990-0180 A SURVEY ABOUT BENEFICIARY RESPONSES TO SOCIAL SECURITY MESSAGES INCLUDED ON BANK ACCOUNT STATEMENTS
0990-0178 TEENAGE PARENT DEMONSTRATION CASE MANAGER QUESTIONNAIRE
0990-0177 AUDIT OF SSA'S USE OF THE FORM-SSA-721, STATEMENT OF DEATH AND BURIAL EXPENSES BY FUNERAL DIRECTORS
0990-0176 TEENAGE PARENT DEMONSTRATION CHILD CARE USER AND PROVIDER QUESTIONNAIRES
0990-0175 PREFERRED PROVIDER ORGANIZATION STUDY
0990-0174 45 CFR PART 95.600 STATE REQUESTS FOR HHS APPROVAL OF FEDERAL FINANCIAL PARTICIPATION IN THE COST OF ADP SYSTEMS, EQUIPMENT AND SERVICES
0990-0173 ACCESS TO APPROPRIATE POST-HOSPITAL CARE: A PILOT STUDY.
0990-0171 FY 1995 SOCIAL SECURITY CLIENT SATISFACTION SURVEY
0990-0169 Uniform Administrative Requirements for Grants and Cooperative Agreements to State and Local Governments
0990-0168 PROGRAM INSPECTION OF THE EXTENT OF USE AND THE ACCURACY OF SOCIAL SECURITY NUMBERS BY AGENCIES AND PROGRAMS EXTERNAL TO SSA
0990-0167 PROGRAM INSPECTION ON MEDICAID ESTATE RECOVERY
0990-0166 FOLLOW-UP TO THE 1983 PHYSICIANS' PRACTICE COSTS AND INCOME SURVEY (PPCIS)
0990-0165 REVIEW OF OXYGEN CONCENTRATOR RENTAL CHARGES TO PART B OF THE MEDICARE PROGRAM
0990-0164 MULTIPLE PROSPECTIVE PAYMENT RELATED STUDIES
0990-0162 State Medicaid Fraud Control Units Annual Report and Recertification Application
0990-0160 45 CFR 95.624 STATE REQUESTS FOR HHS APPROVAL OF FEDERAL FINANCIAL PARTICIPATION IN THE COST OF ADP SYSTEMS, EQUIPMENT AND SERVICES - EMERGENCY SITUATIONS
0990-0159 PROGRAM INSPECTION ON ACCURACY OF SOCIAL SECURITY NUMBERS IN AID TO FAMILIES WITH DEPENDENT CHILDREN/MEDICAID CASES
0990-0157 AWARENESS OF AND ATTITUDES ABOUT SELECTED TYPES OF HEALTH PRODUCTS
0990-0156 REPORTING REQUIREMENTS ARE CONTAINED IN SECTION 1742(A) OF THE RECONCILIATION ACT (31 U.S.C. 1243 NOTE) AND SECTION 675(D) AND (C) OF THE RECONCILIATION ACT (42 U.S.C. 9904(D)
0990-0155 EXPLORATORY SURVEY OF ADVISORY COMMITTEE MEMBERS
0990-0153 THE PREFERRED PROVIDER ORGANIZATION STUDY
0990-0152 PROGRAM INSPECTION OF ADMINISTRATIVE COSTS OF HEAD START GRANTEES
0990-0151 NATIONAL DIAGNOSIS RELATED GROUP (DRG) VALIDATION STUDY
0990-0150 Uniform Relocation and Real Property Acquisition Under Federal and Federally Assisted programs
0990-0149 UPDATE STUDY OF CONSUMER COMPLAINT HANDLING BY GOVERNMENT, BUSINESS AND VOLUNTARY GROUPS
0990-0148 FEDERAL CLAIMS COLLECTION - 45 CFR 30.15(L), 30.19
0990-0147 OFFICE OF COMMUNITY SERVICES DISCRETIONARY GRANT APPLICATION
0990-0146 PROGRAM INSPECTION OF INTEREST BEARING ACCOUNTS OF OFFICE OF HUMAN DEVELOPMENT SERVICES AND PUBLIC HEALTH SERVICE GRANTEES
0990-0145 EVALUATION OF THE USES OF THE DHHS/USDA DIETARY GUIDELINES
0990-0141 HEALTH CARE PROGRAM VIOLATIONS NOTIFICATION FORM
0990-0139 HHS Acquisition Regulation - HHSAR Subpart 315.4 - Solicitation and Receipt of Proposals and Quotations
0990-0138 Types of Contracts -- HHS Acquisition Regulation (HHSAR) Part 316
0990-0137 HHS ACQUISITION REGULATIONS - HHS PART 323 - ENVIRONMENT, CONSERVATION, AND OCCUPATIONAL SAFETY
0990-0136 HHS Acquisition Regulation - HHSAR Part 324 Protection of Privacy and Freedom of Information
0990-0135 HHS ACQUISITION REGULATIONS - HHSAR PART 328 - BONDS AND INSURANCE
0990-0134 Contract Financing -- HHS Acquisition Regulation (HHSAR) Part 332
0990-0133 HHS Acquisition Regulation - HHSAR Part 333 - Disputes and Appeals
0990-0132 HHS ACQUISITION REGULATIONS - HHSAR PART 337 - SERVICE CONTRACTING
0990-0131 HHS Acquisition Regulation - HHSAR Part 342 - Contract Administration
0990-0130 Solicitation Provisions and Contracts Clauses (HHSAR Part 352)
0990-0129 Special Programs Affecting Acquisition (HHSAR Part 370)
0990-0128 HHS Acquisition Regulations: HHSAR Section 352.270-9 and Section 252.223-70
0990-0127 FRONT-END AUTOMATED ELIGIBILITY VERIFICATION SYSTEMS SURVEY
0990-0125 RURAL DEVELOPMENT LOAN FUND (RDLF) REPORTING FORMS
0990-0124 Self-Evaluation & Recordkeeping Required by Regulations Implementing Section 504 of the Rehabilitation Act of 1973
0990-0123 COMMUNITY DEVELOPMENT CREDIT UNION (CDCU) - COMMUNITY NEEDS PLAN
0990-0122 CLEARINGHOUSE QUESTIONNAIRE
0990-0121 COMMUNITY DEVELOPMENT CREDIT UNION PROGRAM
0990-0120 RURAL DEVELOPMENT LOAN FUND
0990-0119 PROVIDER DATA COLLECTION
0990-0118 IMPLEMENTATION OF THE EQUAL ACCESS TO JUSTICE ACT IN AGENCY PROCEEDINGS--SUBPART B
0990-0117 VULNERABILITY SURVEY
0990-0116 EVALUATION OF NIDA DRUG ABUSE PREVENTION MEDIA CAMPAIGN
0990-0115 HHS Acquisition Regulation - Solicitation and Contracts
0990-0114 NONDISCRIMINATION ON THE BASIS OF HANDICAP RELATING TO HEALTH CARE FOR HANDICAPPED INFANTS
0990-0111 EVALUATION OF THE COST AND UTILIZATION PATTERNS OF VARIOUS PHYSICIANS' PRACTICE ARRANGEMENT
0990-0110 CAPABILITY OF 8(A) *CONTRACTORS *(SECTION 8(A) OF THE SMALL BUSINESS ACT)
0990-0109 HHS PROCUREMENT REGULATION
0990-0108 INFORMAL CAREGIVERS SURVEY FOLLOW-UP
0990-0107 1983 SURVEY OF CONSUMER FINANCES/PENSION PROVIDER FOLLOW-UP
0990-0106 PILOT SHORT-TERM EVALUATION OF HHS CLEARINGHOUSE USERS (USER SURVEY)
0990-0103 SURVEY OF STATE/LOCAL GENERAL ASSISTANCE AND REFUGEE ASSISTANCE PROGRAMS
0990-0102 INFORMAL CAREGIVER SURVEY, BASELINE INSTRUMENT
0990-0101 SURVEY PRIVATELY CONTRACTED INDIVIDUALS
0990-0100 RECIPIENT EARNINGS PER MONTH FOR CALENDAR YEAR 1980
0990-0099 NATIONAL LONG-TERM CARE DEMONSTRATION FOLLOW-UP INSTRUMENT
0990-0098 PAYMENT VOUCHER ON LETTER OF CREDIT TFS 5401
0990-0097 REQUEST FOR FUNDS, TFS 5805
0990-0096 Hill-Burton Community Service Assurance Report Triennial IV
0990-0094 SURVEY OF INFORMAL CAREGIVERS
0990-0093 UTILIZATION OF PRODUCTS DISSEMINATED BY THE NATIONAL DIABETES INFORMATION CLEARINGHOUSE
0990-0092 REPORTING AND RECORDKEEPING REQUIREMENTS OF P.L. 97-35 ON THE COMMUNITY SERVICES BLOCK GRANT PROGRAM
0990-0091 HHS ACQUISITION REGULATIONS - HHSAR PART 353 - FORMS
0990-0088 PERSONNEL REPORT (CDC AND VENTURES)
0990-0087 VENTURE ANALYSIS REPORT
0990-0086 GRANTEE WORK PROGRAM SUMMARY AND APPLICATION CERTIFICATION
0990-0082 A STUDY OF THE FINANCING OF GRADUATE MEDICAL EDUCATION
0990-0081 REPORT OF ACCOUNTABLE PERSONAL PROPRITY
0990-0080 NATIONAL LONG-TERM CARE DEMONSTRATION CLIENT TRACKING FORM, CONTACT LONG AND EMPLOYEE TIME SHEET
0990-0079 EVALUATION OF THE MEDICARE MENTAL HEALTH DEMONSTRATION NATIONAL SURVEY
0990-0078 FEDERAL CASH TRANSACTION REPORT
0990-0077 LONG-TERM CARE SURVEY (SURVEY OF IMPAIRED INDIVIDUALS IN HOUSEHOLDS)
0990-0076 HEALTH INSURANCE STUDY - ANNUAL INCOME REPORT
0990-0074 NATIONAL LONG-TERM CARE DEMONSTRATION SCREENING AND BASELINE ASSESSMENT INSTRUMENT
0990-0073 COST ALLOCATION PLANS SUBMITTED BY STATE PUBLIC ASSISTANCE AGENCIES.
0990-0072 HEALTH INSURANCE MEDICAL HISTORY QUESTIONNAIRE
0990-0071 NONFARM SELF-EMPLOYMENT DATA COLLECTION
0990-0070 TENTH WAVE SURVEY OF SOUTHEAST ASIAN REFUGEES: (A) SHORT FORM, (B) LONG FORM
0990-0069 EVALUATION OF THE MEDICARE MENTAL HEALTH DEMONSTRATION
0990-0068 BENEFICIARY INTERVIEW QUESTIONNAIRE
0990-0065 THE SURVEY OF INCOME AND PROGRAM PARTICIPATION
0990-0064 1. THE SURVEY OF INCOME AND PROGRAM PARTICIPATION 2. THE SURVEY OF INCOME AND PROGRAM PARTICIPATION (WAVE ONE & TWO) PRETEST
0990-0063 EVALUATION OF BOARD AND CARE HOMES, INTERMEDIATE CARE FACILITIES, AND SINGLE ROOM OCCUPANCIES
0990-0062 COMMUNITY SURVEY FOR THE EVALUATION OF RURAL PRIMARY CARE DELIVERY MODELS
0990-0060 CUBAN/HAITIAN ENTRANT SPONSORSHIP BREAKDOWN SURVEY
0990-0059 REQUEST FOR ADVANCE OR REIMBURSEMENT
0990-0058 45 CFR PART 95.600 STATE REQUESTS FOR HHS APPROVAL OF FEDERAL FINANCIAL PARTICIPATION IN THE COST OF ADP SYSTEMS, EQUIPMENT AND SERVICES
0990-0057 READERS SURVEY FOR CONSUMER ACTION UPDATE
0990-0056 CONSUMER RESPONSE CHECKLIST FOR E.O. 12160; E.O. 12160 COMPLIANCE CHECKLIST
0990-0055 SURVEY OF STATE AND LOCAL AFDC ADMINISTRATION
0990-0054 RECIPIENT SURVEY FOR THE MONTHLY REPORTING AND RETROSPECTIVE ACCOUNTING STUDY IN ILLINOIS
0990-0053 SECTION 504 REGIONAL TECHNICAL ASSISTANCE PRIORITIES
0990-0052 DATA FORM FOR CONSUMER PUBLICATIONS BIBLIOGRAPHY
0990-0050 INSURANCE VALIDATION
0990-0049 SURVEY INSTRUMENTS FOR EXPLORATORY STUDY OF SENIOR CENTERS
0990-0047 TITLE OF FORM OR DOCUMENT SUBMITTED PARENT IMPACT SATISFACTION INDICATOR: A) POST CARD, B) MAIL SURVEY, AND C) PERSONAL INTERVIEW
0990-0046 INCOME SURVEY DEVELOPMENT PROGRAM: "SPECIAL FRAMES STUDY" BASIC QUESTIONNAIRE AND SELF-EMPLOYMENT QUESTIONNAIRE
0990-0045 AFDC AND FOOD STAMP CLIENT SURVEYS
0990-0043 EVALUATION OF HEW PROGRAMS: SERVICES TO VICTIMS OF DOMESTIC VIOLENCE (A) STATE SURVEY (B) COMMUNITY SURVEY
0990-0040 1980 CHILDREN AND YOUTH REFERRAL SURVEY
0990-0024 STATE RECORDKEEPING REQUIREMENTS FOR REFUGEE SERVICES
0990-0022 STATE REFUGEE ASSISTANCE PERFORMANCE AND FINANCIAL STATUS REPORT
0990-0020 1980 GENERAL HOSPITAL CIVIL RIGHTS SURVEY
0990-0019 A SURVEY OF RESIDENTS OF PENNHURST AND CLA PROGRAMS
0990-0018 FAMILY IMPACT SURVEY
0990-0017 COMMUNITY ATTITUDES SURVEY FOR PENNHURST STUDY
0990-0016 DHHS PROJECT-BY-PROJECT-RESEARCH AWARDS COST SHARING AGREEMENT
0990-0015 Recordkeeping Requirement for Government-Owned/Contractor-Held Property -- HHS 565 Report of Accountable Property
0990-0014 NOTICE TO PATIENT - THIRD PARTY CASE
0990-0012 INCOME SURVEY DEVELOPMENT PROGRAM 1979 RESEARCH PANEL WAVE 6
0990-0011 FEDERAL CASH DISBURSEMENTS
0990-0010 HEALTH REPORT
0990-0008 HEALTH INSURANCE STUDY - ANNUAL INCOME REPORT
0990-0005 HEALTH INSURANCE STUDY, MEDICAL HISTORY, FORM A
0990-0004 ANALYSIS OF GOVERNMENT-OWNED/CONTRACTOR HELD PROPERTY
0990-0003 REPORT OF CAPITALIZED NON-EXPENDABLE EQUIPMENT
0990-0002 PANEL STUDY OF INCOME DYNAMICS (MICH. LONGITUDINAL SURVEY)
0990-0001 Application of Waiver of the 2 Year Foreign Residence Requirement of the Exchange Visitor Program

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