Health Care Provider Survey

Evaluation of the Maternal and Child Health Bureau Pediatric Mental Health Care Access and Screening and Treatment for Maternal Depression and Related Behavioral Disorders Programs Project

OMB: 0906-0052

IC ID: 239850

Information Collection (IC) Details

View Information Collection (IC)

Health Care Provider Survey
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1-1 Attachment B1 - PMHCA Health Care Provider Survey_clean_4-29-2020.docx Attachment B1 - PMHCA Health Care Provider Survey_clean_4-29-2020.docx Yes Yes Fillable Fileable
Form and Instruction 1-1 Tracked Attachment B1 - PMHCA Health Care Provider Survey_tracked_4-29-2020.docx Attachment B1 - PMHCA Health Care Provider Survey_tracked_4-29-2020.docx Yes Yes Fillable Fileable
Form and Instruction 1-2 Attachment B2-MDRBD Health Care Provider Survey_clean_4-29-2020.docx Attachment B2-MDRBD Health Care Provider Survey_clean_4-29-2020.docx Yes Yes Fillable Fileable
Form and Instruction 1-2 Tracked Attachment B2-MDRBD Health Care Provider Survey_tracked_4-29-2020.docx Attachment B2-MDRBD Health Care Provider Survey_tracked_4-29-2020.docx Yes Yes Fillable Fileable

Health Health Care Services

 

13,035 13,035
   
Private Sector Businesses or other for-profits, 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 39,105 0 39,105 0 0 0
Annual IC Time Burden (Hours) 6,648 0 6,648 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