MCH Connects Survey

Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration

OMB: 0915-0212

IC ID: 231166

Information Collection (IC) Details

View Information Collection (IC)

MCH Connects Survey
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 MCH Connects 3 Month Survey- FINAL.docx MCH Connects 3 Month Survey- FINAL.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

53 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 53 0 53 0 0 0
Annual IC Time Burden (Hours) 5 0 5 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
MCH Connect Generic SS +MCH-Connects_Supporting-Statements-FINAL.docx 04/23/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

© 2024 OMB.report | Privacy Policy