MTM Health Department Interview

National Evaluation of the DP18-1815 Cooperative Agreement Program: Category B, Cardiovascular Disease Prevention and Management

OMB: 0920-1311

IC ID: 241428

Information Collection (IC) Details

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MTM Health Department Interview
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a MTM Health Department Interview Guide Att 4e. MTM HD Interview Guide_rev.docx No   Paper Only

Health Public Health Monitoring

 

8 0
   
State, Local, and Tribal Governments
 
   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 8 0 0 0 0 8
Annual IC Time Burden (Hours) 12 0 0 0 0 12
Annual IC Cost Burden (Dollars) 528 0 0 0 0 528

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

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