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Community Health Workers Recipient Survey
[NCCDPHP] Community Health Workers for COVID Response and Resilient Communities’ National Evaluation
OMB: 0920-1411
IC ID: 260598
OMB.report
HHS/CDC
OMB 0920-1411
ICR 202306-0920-005
IC 260598
( )
Documents and Forms
Document Name
Document Type
Community Health Workers Recipient Survey
Form and Instruction
Recipient Survey (English)
Att 4 - Recipient Survey English.pdf
Form and Instruction
Att 4a - Recipient Survey Spanish.pdf
Recepient Survey (Spanish)
IC Document
Information Collection (IC) Details
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