3-Month Follow-up Assessment

Educating and Training of Healthcare Violence Against Women

OMB: 0990-0422

IC ID: 212286

Documents and Forms
Document Name
Document Type
Other-survey
Information Collection (IC) Details

View Information Collection (IC)

3-Month Follow-up Assessment
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-survey 0990-IPV_Follow-up Assessment_6_26_2014.doc Yes Yes Fillable Fileable

Health Health Care Services

 

1,600 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 1,600 0 0 0 0 1,600
Annual IC Time Burden (Hours) 667 0 0 0 0 667
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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