Survey of non-Title X Clinic Providers

Monitoring Changes in Attitudes and Practices among Family Planning Providers and Clinics

OMB: 0920-0969

IC ID: 203902

Information Collection (IC) Details

View Information Collection (IC)

Survey of non-Title X Clinic Providers
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Survey of Health Care Providers about Family Planning Attitudes and Practices Att E-1 2018-2019 Survey of Health Care Providers about Family Planning.doc Yes Yes Fillable Fileable
Form none Survey of Health Care Providers about Family Planning Attitude and Practices - screenshots Att E-2 Screen shots of provider survey.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

1,000 0
   
State, Local, and Tribal Governments
 
   20 %

  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 1,000 0 1,000 0 0 0
Annual IC Time Burden (Hours) 250 0 250 0 0 0
Annual IC Cost Burden (Dollars) 8,840 0 8,840 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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