Community Nursing Home (CNH) Dementia ECHO: Staff Education Evaluation

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NCA, VBA, VHA)

OMB: 2900-0770

IC ID: 235759

Documents and Forms
Document Name
Document Type
Other-Questionnaire
Other-Questionnaire
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Community Nursing Home (CNH) Dementia ECHO: Staff Education Evaluation 2900-0770
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Questionnaire CNH Dementia ECHO Staff Education Questionnaire_OMB passback revisions_July 2019_Final.docx No   Paper Only
Other-Questionnaire CNH Dementia ECHO Staff Education Questionnaire_Final_April 2019.docx No   Paper Only

Health Health Care Services

 

150 0
   
Individuals or Households
 
   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 150 0 150 0 0 0
Annual IC Time Burden (Hours) 25 0 25 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Generic Clearance Statement_CNH Dementia ECHO Educ_May 2019 Generic Clearance Submission Template_Final_May 2019.doc 05/23/2019
Generic Clearance Supporting Statement Dementia ECHO_Generic Clearance Statement_OMB passback revisions_July 2019_Final.doc 07/30/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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