DSMES Partner Site-Level Rapid Evaluation Nomination

National Evaluation of the DP18-1815 Cooperative Agreement Program: Category A, Diabetes Management and Type 2 Diabetes Prevention

OMB: 0920-1312

IC ID: 241401

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DSMES Partner Site-Level Rapid Evaluation Nomination
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a DSMES Site-Level Rapid Evaluation - Site Nomination Form (screen shots) Att 4aa. DSMES Nom Form Screenshots.pdf Yes Yes Fillable Fileable
Other-WORD view of screen shot content Att 4a. DSMES Site Nom Form.docx No   Paper Only

Health Public Health Monitoring

 

17 0
   
State, Local, and Tribal Governments
 
   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 17 0 17 0 0 0
Annual IC Time Burden (Hours) 9 0 9 0 0 0
Annual IC Cost Burden (Dollars) 374 0 374 0 0 0

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