Telehealth Performance Measurement Report

Evidence Based Telehealth Network Program Measures

OMB: 0906-0043

IC ID: 237634

Information Collection (IC) Details

View Information Collection (IC)

Telehealth Performance Measurement Report
 
No New
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 2 FORM_Telehealth Performance Measurement Report RESPONSE CLEAN.docx FORM_Telehealth Performance Measurement Report RESPONSE CLEAN.docx Yes Yes Fillable Fileable
Form 2 Telehealth Performance Measurement Report.docx FORM_Telehealth Performance Measurement Report.docx Yes Yes Fillable Fileable

Health Health Care Services

 

14 0
   
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 14 0 14 0 0 0
Annual IC Time Burden (Hours) 70 0 70 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

© 2024 OMB.report | Privacy Policy