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Instrument 4: Guide for Implementation Study for Referral Provider Administrators

IC 232048 under ICR 202108-0970-015 · OMB 0970-0514.

Documents and Forms
Document Name
Document Type
Other-Implementation Study Guide
Other-Implementation Study Guide
Information Collection (IC) Details

View Information Collection (IC)

Instrument 4: Guide for Implementation Study for Referral Provider Administrators
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Implementation Study Guide Instrument 4 Guide for Implementation Study for Referral Provider Administrators.docx No   Paper Only

Community and Social Services Social Services

 

2 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 1 0 -4 0 0 5
Annual IC Time Burden (Hours) 1 0 -4 0 0 5
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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