EHR Readiness Checklist

The Health Center Program Application Forms

OMB: 0915-0285

IC ID: 207850

Documents and Forms
Information Collection (IC) Details

View Information Collection (IC)

EHR Readiness Checklist
 
No Removed
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 1 EHR Readiness Checklist 35. EHR Readiness Checklist.docx Yes No Fillable Fileable

Health Illness Prevention

 

50 0
   
Private Sector Not-for-profit institutions
 
   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 0 0 0 -50 0 50
Annual IC Time Burden (Hours) 0 0 0 -25 0 25
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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