OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Health Center Youth Survey

IC 222373 under ICR 201912-0920-012 · OMB 0920-1156.

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

View Information Collection (IC)

Health Center Youth Survey
 
No Removed
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction NA Helath Center Youth Survey Att 6 Health Center Youth Survey_6 22 2016.docx NA No   Paper Only

Health Health Care Services

 

1,050 0
   
Individuals or Households
 
   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 0 0 0 -1,050 0 1,050
Annual IC Time Burden (Hours) 0 0 0 -175 0 175
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.