Quarterly Health Center Perfoemance Measure Reporting Tool

Performance Monitoring of “Working with Publicly Funded Health Centers to Reduce Teen Pregnancy among Youth from Vulnerable Populations

OMB: 0920-1156

IC ID: 222375

Information Collection (IC) Details

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Quarterly Health Center Perfoemance Measure Reporting Tool
 
No Unchanged
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction NA Quarterly Health Center Performance Measure Reporting Tool Att 7 Quarterly Health Center Performance Measure Reporting Tool.docx NA No   Paper Only

Health Health Care Services

 

4 0
   
State, Local, and Tribal Governments
 
   0 %

  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 12 0 0 0 0 12
Annual IC Time Burden (Hours) 48 0 0 0 0 48
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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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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