Annual Health Center Performance Measure Reporting Tool

Performance Monitoring of “Working with Publicly Funded Health Centers to Reduce Teen Pregnancy among Youth from Vulnerable Populations

OMB: 0920-1156

IC ID: 222366

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Annual Health Center Performance Measure Reporting Tool
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1156 Annual Health Center Performance Measure Reporting Tool Att 6a Annual Health Center Performance Measure Reporting Tool 6_22_2016.docx Yes Yes Fillable Fileable
Form and Instruction 0920-1156 Annual Health Center Performance Measure Reporting Tool Online Att 6b Annual Health Center Performance Measure Reporting Tool Online Version.docx Yes Yes Fillable Fileable

Health Health Care Services

 

21 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   0 %

  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 21 0 0 0 0 21
Annual IC Time Burden (Hours) 126 0 0 0 0 126
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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