Information Collection Request

Million Hearts Hypertension Control Challenge

ICR 202209-0920-028 · OMB 0920-0976 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 0920-0976 Interview Guide Form and Instruction Modified Repair queued
Form 0920-0976 Million Hearts® Hypertension Control Champion Data Verification Form Form and Instruction Modified Repair queued
Form 0920-0976 Application Form Form and Instruction Modified Repair queued
Attachment 10. Contractors Request for Chart Part 2 0920-0976.docx Supplementary Document Uploaded 2022-09-29 Repair queued
Attachment 9. Contractors Request for Charts Part 1 0920-0976.docx Supplementary Document Uploaded 2022-09-29 Repair queued
Attachment 8. Project Determination_Hypertension Control Challenge.docx Supplementary Document Uploaded 2022-09-29 Repair queued
Attachment 7. Example Business Associate Agreement 0920-0976.docx Supplementary Document Uploaded 2022-09-29 Repair queued
Attachment 2. Published 60 Day FRN.pdf Supplementary Document Uploaded 2022-10-18 Missing upstream
Attachment 1c. Office of Management and Budget Guidance on the Use of Challenges 0920-0976.pdf Supplementary Document Uploaded 2016-09-19 Repair queued
Attachment 1b. Authorizing Legislation 0920-0976.docx Supplementary Document Uploaded 2022-10-18 Repair queued
Attachment 1a. Authorizing Legislation 0920-0976.docx Supplementary Document Uploaded 2022-10-18 Missing upstream
0976 SSB.0976.docx Supporting Statement B Uploaded 2022-09-29 Repair queued
SSA Rev.10.5.22.docx Supporting Statement A Uploaded 2022-10-18 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
206922 Interview Guide Form and Instruction Modified
206921 Million Hearts® Hypertension Control Champion Data Verification Form Form and Instruction Modified
206920 Application Form Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 11/30/2022
275 275
215 215
0 0





table that charts list of burden
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 275 275 0 0 0 0
Annual Time Burden (Hours) 215 215 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No