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Mashpee Wampanoag Indian Health Service Unit Community Health Assessment

IC 231678 under ICR 201707-0917-001 · OMB 0917-0039.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
IC Document
IC Document
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Mashpee Wampanoag Indian Health Service Unit Community Health Assessment
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0917-Mashpee Mashpee Wampanoag Indian Health Service Unit Community Health Assessment IHS Mashpee CHA_Survey_STC-FINAL VERSION-Changed Questions 5.18.18.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

324 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 324 0 324 0 0 0
Annual IC Time Burden (Hours) 135 0 135 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Mashpee Wampanoag Indian Health Service Unit Community Health Assessment Part A Mashpee Wampanoag Indian Health Service Unit Community Health Assessment.docx 06/07/2018
Mashpee Wampanoag Indian Health Service Unit Part B Part B- Mashpee Wampanoag Indian Health Service Unit Community Health Assessment.docx 06/07/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.