BHPr Funding Strategy Evaluation- Expansion of Physician Assistant Training

Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0212 can be found here:

Documents and Forms

Document Name Document Type
Form 1 BHPr Funding Strategy Evaluation- Expansion of Physician Assistant Training Form
1 EPAT Eligible Funded Script - EPAT Eligible Applicants Applied Funded-1 25 11 Final.docx Form
2 EPAT- Eligible Inquiry Did Not Apply Script -EPAT Eligible Applicants Inquiry Did Not Apply-1 25 11 Final.docx Form
3 EPAT- Eligible No Inquiry Did Not Apply Script - EPAT Eligible Organizations no inquiry did not apply-1 25 11 Final.docx Form
BHPR-EPAT Funding Strategy Eval Project-FINAL Supporting Statement-2.3.11.docx BHPr Funding Strategy Evaluation - EPAT Supporting Statement IC Document
Evaluation Interview One-pager - EPAT.docx BHPr Funding Strategy-EPAT Informational One Pager IC Document

Information Collection (IC) Details

IC Title:	BHPr Funding Strategy Evaluation- Expansion of Physician Assistant Training	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	EPAT Eligible Funded	Script - EPAT Eligible Applicants Applied Funded-1 25 11 Final.docx	No	No	Printable Only
Form	2	EPAT- Eligible Inquiry Did Not Apply	Script -EPAT Eligible Applicants Inquiry Did Not Apply-1 25 11 Final.docx	No	No	Printable Only
Form	3	EPAT- Eligible No Inquiry Did Not Apply	Script - EPAT Eligible Organizations no inquiry did not apply-1 25 11 Final.docx	No	No	Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 110	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 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	110	0	0	0	0	0
Annual IC Time Burden (Hours)	32	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
BHPr Funding Strategy Evaluation - EPAT Supporting Statement	BHPR-EPAT Funding Strategy Eval Project-FINAL Supporting Statement-2.3.11.docx	02/03/2011
BHPr Funding Strategy-EPAT Informational One Pager	Evaluation Interview One-pager - EPAT.docx	02/03/2011

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