Chronic Disease Self-Management Education Program

Chronic Disease Self-Management Education Program

OMB: 0985-0036

IC ID: 206269

Information Collection (IC) Details

View Information Collection (IC)

Chronic Disease Self-Management Education Program
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Workshop InfoCover Sheet Attachment L Workshop Info Cover Sheet.pdf Yes Yes Fillable Fileable
Form and Instruction 3 Attendance Log Attachment N Attendance Log.pdf Yes Yes Fillable Fileable
Form and Instruction 2 Participant Information Survey Attachment M Participant Information Survey.pdf Yes Yes Fillable Fileable
Form and Instruction 4 Organization Site Types Attach_P_Organization_Site_Types_508.pdf Yes Yes Fillable Fileable

Community and Social Services Social Services

 

28,056 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 28,056 0 28,056 0 0 0
Annual IC Time Burden (Hours) 3,550 0 3,550 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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