Special Emphasis Panel (SEP) Peer Review Evaluation for Quality Improvement

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

OMB: 0920-1050

IC ID: 239208

Information Collection (IC) Details

View Information Collection (IC)

Special Emphasis Panel (SEP) Peer Review Evaluation for Quality Improvement 0920-1050-20FM
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1050 Peer Reviewers Evaluation Form Att 1_Peer Reviewers' Evaluation Form final.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

500 0
   
Individuals or Households
 
   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 500 0 500 0 0 0
Annual IC Time Burden (Hours) 167 0 167 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Template Information 0920-1050 _Service Delivery_SEP Peer Review Evaluation final.docx 01/09/2020
PIA email Att 2_PIA Email.pdf 01/09/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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