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Survey on Gender, Ethnic and Racial Backgrounds of Clients and Staff at Bureau of Primary Health Care Supported Community-Based Health Service Sites

IC 6515 under ICR 200208-0915-002 · OMB 0915-0265.

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Information Collection (IC) Details

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Survey on Gender, Ethnic and Racial Backgrounds of Clients and Staff at Bureau of Primary Health Care Supported Community-Based Health Service Sites
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form HRSA-106 No No
Form HRSA-105 No No


    

300 0
   
Individuals or Households
 
   0 %

  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 11,250 0 11,250 0 0 0
Annual IC Time Burden (Hours) 1,000 0 1,000 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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