TRC Performance Indicator Data Collection Tool

Performance Improvement Measurement System for the Office for the Advancement of Telehealth, Telehealth Resource Center Program

OMB: 0915-0361

IC ID: 205420

Documents and Forms
Information Collection (IC) Details

View Information Collection (IC)

TRC Performance Indicator Data Collection Tool
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction D TRC Performance Indicator Data Collection Tool AttachDRCInstrument_2018.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

14 14
   
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 588 0 0 0 0 588
Annual IC Time Burden (Hours) 41 0 0 0 0 41
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.

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