Patient Navigator ultural Competency Checklist

Patient Navigator Outreach and Chronic Disease Prevention Demonstration Program

OMB: 0915-0346

IC ID: 198110

Information Collection (IC) Details

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Patient Navigator ultural Competency Checklist
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 10 Cultural Competency HRSA_Patient_Navigator_Demonstration_Program_Cultural_Competency_Checklist.doc Yes Yes Fillable Fileable

Health Health Care Services

 

10 0
   
Private Sector Not-for-profit institutions
 
   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 46 0 46 0 0 0
Annual IC Time Burden (Hours) 54 0 54 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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