Follow-up Survey -Community Health workers

OS Think Cultural Health

OMB: 0990-0407

IC ID: 219185

Documents and Forms
Information Collection (IC) Details

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Follow-up Survey -Community Health workers
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-forms 0990-0407Appendix D - TCH Follow-Up Survey (Community Health Workers)(12.2.15).pdf Yes Yes Fillable Fileable

Health Health Care Services

 

6 0
   
Private Sector Businesses or other for-profits
 
   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 12 0 0 0 0 12
Annual IC Time Burden (Hours) 2 0 0 0 0 2
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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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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