Maternal, Infant, and Early Childhood Home Visiting Program HV-ImpACT Technical Assistance Program Feedback and Satisfaction Surveys

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

OMB: 0915-0212

IC ID: 232937

Information Collection (IC) Details

View Information Collection (IC)

Maternal, Infant, and Early Childhood Home Visiting Program HV-ImpACT Technical Assistance Program Feedback and Satisfaction Surveys
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form A Attachment A-Annual Satisfaction Survey.docx Attachment A-Annual Survey.docx Yes Yes Fillable Fileable
Form B Attachment B-HV-ImpACT Event Survey.docx Attachment B-HV-ImpACT Event Survey.docx Yes Yes Fillable Fileable
Form C Attachment C-Community of Practice Survey.docx Attachment C-Community of Practice Survey.docx Yes Yes Fillable Fileable
Form D Attachment D-Targeted TA Project Officer survey.docx Attachment D-Targeted TA Project Officer survey.docx Yes Yes Fillable Fileable
Form E Attachment E-Newsletter Survey.docx Attachment E-Newsletter Survey.docx Yes Yes Fillable Fileable

Health Health Care Services

 

2,290 0
   
State, Local, and Tribal Governments
 
   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 3,100 0 3,100 0 0 0
Annual IC Time Burden (Hours) 256 0 256 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement A Supporting Statement DHVECS HV-ImpACT TA Surveys_2018.docx 09/07/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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