Document
Home-based Provider Screener and Questionnaire (Spanish)
ICR 201808-0970-002 · OMB 0970-0391 · Object 85459401.
This document may belong to an older filing. More recent activity for OMB 0970-0391:
Document Viewer [docx]
Status: The document is viewable, but some background extraction is still pending.
Queue: Repair is queued and waiting for the next worker pass. (priority 140 · next 2026-05-07 00:39:01)
Download: Source copy (docx)
Loading document viewer…
Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | Home-based Provider Screener and Questionnaire (Spanish) |
| File Created | 2021-01-20 |
| Conversion State | partial |