Self-administered implementation surveys with clinical staff at 30 months

Safety Program in Perinatal Care (SPPC)-II Demonstration Project

OMB: 0935-0246

IC ID: 237428

Information Collection (IC) Details

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Self-administered implementation surveys with clinical staff at 30 months
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction N Self-administered implementation surveys with clinical staff at 30 months Attachment N - Clinical staff self-administered implementation survey at 30 months.docx Yes Yes Fillable Fileable
Form Q Consent form - Self-administered implementation surveys with clinical staff at 30 months Attachment Q Consent form for clinical staff self-administered implementation survey at 30 months.docx Yes Yes Fillable Fileable

Health Health Care Services

 

774 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   50 %

  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 774 0 774 0 0 0
Annual IC Time Burden (Hours) 387 0 387 0 0 0
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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