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Million Hearts® Hypertension Control Champion Data Verification Form

IC 206921 under ICR 202209-0920-028 · OMB 0920-0976.

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

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Million Hearts® Hypertension Control Champion Data Verification Form 0920-0976
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-0976 Million Hearts® Hypertension Control Champion Data Verification Form Attachment 4. Verification Form 0920-0976 (unchanged).docx Yes Yes Fillable Fileable

Health Immunization Management

 

40 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   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 40 0 0 0 0 40
Annual IC Time Burden (Hours) 80 0 0 0 0 80
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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