Preventive Health and Health Services Block Grant Assessment

Assessment of Outcomes Associated with the Preventive Health and Health Services Block Grant

OMB: 0920-1257

IC ID: 234732

Information Collection (IC) Details

View Information Collection (IC)

Preventive Health and Health Services Block Grant Assessment 0920-18AUV
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-WORD Attachment D_Instrument Word Version.docx No   Paper Only
Form 0920-XXXX Preventive Health and Health Services Block Grant Assessment Attachment E - Instrument Web Version.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

61 0
   
State, Local, and Tribal Governments
 
   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 61 0 61 0 0 0
Annual IC Time Burden (Hours) 46 0 46 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Invitation Email Attachment I - Invitation Email.docx 01/17/2019
Reminder Email Attachment J - Reminder Email.docx 01/17/2019
Final Reminder Email Attachment K - Final Reminder Email.docx 01/17/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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