Sickle Cell Disease Treatment Demonstration Program (SCDTDP) Evaluation - Quality Improvement Instrument

Sickle Cell Disease Program Evaluations

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0344 can be found here:

Documents and Forms

Document Name Document Type
Form 008_Sickle Cell_QI Sickle Cell Disease Treatment Demonstration Program (SCDTDP) Evaluation - Quality Improvement Instrument Form
008_Sickle Cell_QI 008_Sickle Cell_QI Instrument SCDTDP Quality Improvement Instrument.docx Form

Information Collection (IC) Details

IC Title:	Sickle Cell Disease Treatment Demonstration Program (SCDTDP) Evaluation - Quality Improvement Instrument	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	008_Sickle Cell_QI Instrument	008_Sickle Cell_QI Instrument	SCDTDP Quality Improvement Instrument.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 9	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	108	108
Annual IC Time Burden (Hours)	432	432
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.