Program Data Collection Tool

Evaluation and Initial Assessment of HRSA Teaching Health Centers

OMB: 0915-0376

IC ID: 208624

Documents and Forms
Information Collection (IC) Details

View Information Collection (IC)

Program Data Collection Tool
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Program Data Collection Tool Instrument - Program Data Collection Tool.docx Yes Yes Fillable Fileable

Health Illness Prevention

 

45 0
   
Individuals or Households
 
   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 45 0 45 0 0 0
Annual IC Time Burden (Hours) 360 0 360 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.

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