OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Evaluation of a Prevention Information Prototype in the Context of a HRSA Community Health Center

IC 185676 under ICR 200706-0990-004 · OMB 0990-0281.

Documents and Forms
Document Name
Document Type
Other-survey
Other-survey
Other-survey
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Evaluation of a Prevention Information Prototype in the Context of a HRSA Community Health Center
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-survey Pre Survey_0990_0281_#10 (3).doc No No Paper Only
Other-survey Post Survey_0990_0281_#10 (3).doc No No Paper Only
Other-survey 30 Day Follw up_0990_0281_#10 (3).doc No No Paper Only

Health Public Health Monitoring

 

500 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 500 0 0 0 0 0
Annual IC Time Burden (Hours) 117 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
OMB Memo 0990-0281_#10 (2) OMB Memo 0990-0281_#10 (2).doc 07/10/2008
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.