Patient Navigator Demonstration Program Evaluation - Patient Navigator Level

Patient Navigator Demonstration Program Evaluation

OMB: 0915-0328

IC ID: 188563

Information Collection (IC) Details

View Information Collection (IC)

Patient Navigator Demonstration Program Evaluation - Patient Navigator Level
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Data Dictionary Attachment A - HRSA PNDP Data Dictionary.pdf Yes Yes Fillable Fileable
Form 001 - Patient Navigator Tracking Log Patient Navigator Tracking Log Attachment B - Patient Tracking Log.pdf Yes Yes Fillable Printable

Health Health Care Services

 

30 0
   
Individuals or Households
 
   100 %

  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 22,530 22,530 0 0 0 0
Annual IC Time Burden (Hours) 5,633 5,633 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

© 2024 OMB.report | Privacy Policy