Information Collection

Work Force Recruitment in BPHC-Funded Health Centers Survey

IC 203614 under ICR 201208-0915-001 · OMB 0915-0353.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0353 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Work Force Recruitment in BPHC-Funded Health Centers Survey	Form and Instruction
1 HC Workforce Recruitment Screenshots of HC Work Force Recruitment Survey_Fi (7.26.12).doc	Form and Instruction

IC Title:

Work Force Recruitment in BPHC-Funded Health Centers Survey

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	HC Workforce Recruitment	Screenshots of HC Work Force Recruitment Survey_Fi (7.26.12).doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,200

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,200	1,200
Annual IC Time Burden (Hours)	600	600
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.