OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Indian Health Service National Health Coaching Pilot Project Registration

IC 250384 under ICR 202201-0917-001 · OMB 0917-0036.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Indian Health Service National Health Coaching Pilot Project Registration
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0917-0036 HCW Application HWC Web Content questions 11.16.21 final.docx Yes Yes Fillable Fileable

Health Health Care Services

 

100 0
   
Individuals or Households
 
   100 %

  Requested 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 100 0 0 0 0 100
Annual IC Time Burden (Hours) 8 0 0 0 0 8
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Submission Template HWC DCCS-NHCPP Registration Clearance Submission Request-IHS 11.16.21 final.docx 11/17/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.