Maternal and Child Health Nutrition Training Needs Assessment

Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0212 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Maternal and Child Health Nutrition Training Needs Assessment Form and Instruction
1 Survey MCH Nutrition Training Needs Assessment.docx FORM_Survey MCH Nutrition Training Needs Assessment.docx Form and Instruction
TNA for MCH nutrition Supporting Statement 7-20.docx Supporting Statement A IC Document

Information Collection (IC) Details

IC Title:	Maternal and Child Health Nutrition Training Needs Assessment	Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Survey MCH Nutrition Training Needs Assessment.docx	FORM_Survey MCH Nutrition Training Needs Assessment.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 65	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	65	65
Annual IC Time Burden (Hours)	16	16
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement A	TNA for MCH nutrition Supporting Statement 7-20.docx	07/16/2020

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.