Information Collection Request

OS Think Cultural Health

ICR 201511-0990-001 · OMB 0990-0407 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
OS Think- 0990-0407_Supporting Statement_TCH Revised Data Collection_OMB (3.29#2).doc Supporting Statement A Uploaded 2016-03-29 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
219188 Key Informant interview-Community Health Workers Other-interview New
219187 Key Informant interview Other-interview New
219186 Focus Groups- Health and Health Care Other-Focus Group New
219185 Follow-up Survey -Community Health workers Other-forms New
219184 Follow-up Survey -Health and Healthcare Professionals Other-forms New
219105 TCH Course/Unit Evaluation Form Other-Course New
219104 TCH Registration Form Other-form New
205362 other Other-instrument Removed
205361 Student Other-instrument Removed
205360 Doctorate Other-instrument Removed
205359 Masters Other-instrument Removed
205358 Bachelors Other-instrument Removed
205357 Lawyer Other-instrument Removed
205356 Teacher Other-instrument Removed
205355 Policymaker or Public Official Other-instrument Removed
205354 Administrator or Hospital Executive Other-instrument Removed
205353 Emergency Medical Technician Other-instrument Removed
205352 Pharmacist, RPH Other-instrument Removed
205351 Mental Health Professional Other-instrument Removed
205350 Psycologist/Psychiatrist Other-instrument Removed
205349 General Healthcare Worker Other-instrument Removed
205348 public Health Other-instrument Removed
205347 Social Worker Other-instrument Removed
205346 Dental Professional Other-instrument Removed
205345 Dentist Other-instrument Removed
205344 Physician Assistant Other-instrument Removed
205343 Nurse Other-instrument Removed
205342 Physician Other-form Removed

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
03/31/2019 36 Months From Approved 04/30/2016
23,193 0 118,692
2,032 0 5,936
0 0 0





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 23,193 118,692 0 -95,499 0 0
Annual Time Burden (Hours) 2,032 5,936 0 -3,904 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No