OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Awardee interviews for the evaluation of the Advance Interoperable Health Information Technology to Support Health Information Exchange program

IC 227583 under ICR 201408-0955-001 · OMB 0955-0003.

Documents and Forms
Document Name
Document Type
Other-Instruction
Other-FAQ
Other-interview
Other-guide
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Awardee interviews for the evaluation of the Advance Interoperable Health Information Technology to Support Health Information Exchange program
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Instruction 0955-0003 Logic_Model Instructions.docx No   Paper Only
Other-FAQ 0955-0003 Closeout FAQs to send to interviewees.docx No   Paper Only
Other-interview 0955-0003 Interview request template.docx No   Paper Only
Other-guide 0955-0003 AHIE Interview Guide_Final_06-16-2017.docx No   Paper Only

Health Health Care Services

 

12 0
   
Individuals or Households
 
   0 %

  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 12 0 12 0 0 0
Annual IC Time Burden (Hours) 18 0 18 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
memo revisedGeneric_Clearance_Submission_LJ (3).doc 07/19/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.