Site Recruitment and Training

Health Center Patient Survey (HCPS_

OMB: 0915-0368

IC ID: 239085

Information Collection (IC) Details

View Information Collection (IC)

Site Recruitment and Training
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 2 Attachment10 National_Awardee and Site Recruitment Materials_3-23-20 Attachment10 National_Awardee and Site Recruitment Materials_final 10_29_2019_psg.docx Yes Yes Fillable Fileable

Health Health Care Services

 

700 0
   
Individuals or Households
 
   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 700 0 0 0 0 700
Annual IC Time Burden (Hours) 2,205 0 0 0 0 2,205
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Receptionist Recruitment Script_Phone_version Receptionist Recruitment Script_Phone_version.docx 12/11/2020
Receptionist Recruitment Script_Chinese_psg Receptionist Recruitment Script_English_TChinese_psg.docx 12/11/2020
Receptionist Recruitment Script_Spanish_psg Receptionist Recruitment Script_Spanish_psg.docx 12/11/2020
Receptionist Recruitment Script_Viet_psg Receptionist Recruitment Script_Viet_psg.docx 12/11/2020
Interviewer Recruitment Script final_Phone_version Interviewer Recruitment Script final_Phone_version.docx 12/11/2020
Interviewer Recruitment Script final_TChinese_Phone Interviewer Recruitment Script final_TChinese_Phone.docx 12/11/2020
Phone Version Interviewer Recruitment Script final_Spanish_psg Phone Version Interviewer Recruitment Script final_Spanish_psg.docx 12/11/2020
Interviewer Recruitment Script final VIET_psg Interviewer Recruitment Script final VIET_psg.docx 12/11/2020
Attachment 13 Receptionist Recruitment Script at clinic Tagalog_psg Attachment 13 Receptionist Recruitment Script at clinic Tagalog_psg.docx 12/11/2020
Attachment 13 Interviewer Recruitment Script_Tagalog_psg Attachment 13 Interviewer Recruitment Script_Tagalog_psg.docx 12/11/2020
Flyer to Hand to Patients Flyer to Hand to Patients.docx 12/11/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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