Regions IV VI Infant Mortality Collaborative Improvement and Innovation Network (CoIIN) Participant Satisfaction Survey

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

OMB: 0915-0212

IC ID: 212594

Information Collection (IC) Details

View Information Collection (IC)

Regions IV VI Infant Mortality Collaborative Improvement and Innovation Network (CoIIN) Participant Satisfaction Survey
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Regions IV and VI Infant Mortality CoIIN Participant Satisfaction Survey CoIIN Participant Satisfaction Survey PARTS I II.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

65 0
   
State, Local, and Tribal Governments
 
   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 65 0 65 0 0 0
Annual IC Time Burden (Hours) 33 0 33 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement Supporting Statement.docx 08/06/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

© 2024 OMB.report | Privacy Policy