OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

BHPr Performance Measures Forms

IC 206385 under ICR 201804-0915-001 · OMB 0915-0061.

Documents and Forms
Document Name
Document Type
Form and Instruction
Other-Ca Doc Support
Other-Cb Supporting Docs
Other-Cc Supporting Doc
Other-Cd supporting Doc
Other-Ce Supporting Doc
Other-Cf Supporting Doc
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

BHPr Performance Measures Forms
 
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 B Progress Report AttachBProgressReport.docx Yes Yes Fillable Fileable
Form and Instruction C PRGCA AttachCPRGCA.docx Yes Yes Fillable Fileable
Other-Ca Doc Support CaPrimary Care Offices Measures.docx Yes No Printable Only
Other-Cb Supporting Docs CbPerformance Measures.pdf Yes No Printable Only
Other-Cc Supporting Doc CcDNPH Mapping 2015.pdf Yes No Printable Only
Other-Cd supporting Doc CdDMD Mapping 2015.pdf Yes No Printable Only
Other-Ce Supporting Doc CeDHCFS Mapping 2015.pdf Yes No Printable Only
Other-Cf Supporting Doc Performance Measures.pdf Yes No Printable Only

Health Public Health Monitoring

 

1,557 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 1,557 0 0 0 0 1,557
Annual IC Time Burden (Hours) 5,992 0 0 0 0 5,992
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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