Information Collection Request
Evidence Based Telehealth Network Program Measures
ICR 202301-0906-002 · OMB 0906-0043 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0906-0043 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form 1 Telehealth Performance Measurement Report |
Form and Instruction | Modified | Repair queued |
| Form 1 Evidence Based Telehealth Network Program Report |
Form and Instruction | Modified | Repair queued |
 EB THNP SAT Study Protocol.pdf |
Supplementary Document | Uploaded 2023-01-10 | Repair queued |
 OMB Supporting Statement - Evidence Based Telehealth Network Program.docx |
Supporting Statement A | Uploaded 2023-01-10 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 237634 |  Telehealth Performance Measurement Report |
Form and Instruction | Modified | |
| 237633 | Evidence Based Telehealth Network Program Report |
Form and Instruction | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/HRSA |
| OMB Control No | 0906-0043 |
| Type of Information Collection | Reinstatement without change of a previously approved collection |
| Previous ICR Reference No | 201909-0906-001 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |