Surveys of Safety Net Providers for the Healthy Communities Access Program Evaluation

Surveys of Safety Net Providers for the Healthy Communities Access Program Evaluation

OMB: 0915-0296

IC ID: 6551

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Surveys of Safety Net Providers for the Healthy Communities Access Program Evaluation
 
No Migrated
 
Voluntary
 

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


    

550 0
   
Individuals or Households
 
   30 %

  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 550 0 550 0 0 0
Annual IC Time Burden (Hours) 170 0 170 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.

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