Peer Support and Pain Self-Management Education Program Feedback

Fast Track Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0379 can be found here:

Documents and Forms

Document Name Document Type
0990-0379 CPSMPandPS_pre-post-tests.OMB.pdf Other-evaluation
0990-0379 CPSMP-PS_Clearance_Submission.doc Memo Feedback IC Document

Information Collection (IC) Details

IC Title:	Peer Support and Pain Self-Management Education Program Feedback	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-evaluation			0990-0379 CPSMPandPS_pre-post-tests.OMB.pdf		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 66	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	66	66
Annual IC Time Burden (Hours)	22	22
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Memo Feedback	0990-0379 CPSMP-PS_Clearance_Submission.doc	06/18/2019

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.