Understanding Changes to Local Health Department Clinical Service Provision

ASPE Generic Clearance for the Collection of Qualitative Research and Assessment

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0421 can be found here:

Documents and Forms

Document Name Document Type
ASPE_IP_draft_final.pdf Other-survey
0990-0421OMB Cover Sheet_LHD Pos Dev_10-13-15.pdf Understanding Changes to Local Health Department Clinical Service Provision IC Document
SS A_LHD.pdf Suppt A_Understanding Changes to Local Health Department Clinical Service Provision IC Document
0990-0421 SS B_LHD_Pos dev_ASPE.pdf Suppt B_Understanding Changes to Local Health Department Clinical Service Provision IC Document

Information Collection (IC) Details

IC Title:	Understanding Changes to Local Health Department Clinical Service Provision	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-survey			ASPE_IP_draft_final.pdf		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 40	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	40	40
Annual IC Time Burden (Hours)	40	40
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Understanding Changes to Local Health Department Clinical Service Provision	0990-0421OMB Cover Sheet_LHD Pos Dev_10-13-15.pdf	11/09/2015
Suppt A_Understanding Changes to Local Health Department Clinical Service Provision	SS A_LHD.pdf	12/09/2015
Suppt B_Understanding Changes to Local Health Department Clinical Service Provision	0990-0421 SS B_LHD_Pos dev_ASPE.pdf	11/09/2015

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