Primary Care provider Interview Protocol

Frontier Community Healthcare Network Coordination Grant

OMB: 0915-0383

IC ID: 209800

Information Collection (IC) Details

View Information Collection (IC)

Primary Care provider Interview Protocol
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 3 Primary Care Provider Interview Protocol PrimaryCareProviderInterviewGuide_OMBClearancePackage_09242013.docx Yes Yes Paper Only

Health Health Care Services

 

22 0
   
Individuals or Households
 
   0 %

  Requested 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 22 0 22 0 0 0
Annual IC Time Burden (Hours) 11 0 11 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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