Information Collection

Survey Of Primary Care Preventive Services Availability And Provider Practices In Community And Migrant Health Centers

IC 110351 under ICR 199005-0915-003 · OMB 0915-0139.

Documents and Forms

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Document Name	Document Type

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IC Title:

SURVEY OF PRIMARY CARE PREVENTIVE SERVICES AVAILABILITY AND PROVIDER PRACTICES IN COMMUNITY AND MIGRANT HEALTH CENTERS

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 544

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	544	544
Annual IC Time Burden (Hours)	408	408
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.