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Community Health Workers CHW Survey
[NCCDPHP] Community Health Workers for COVID Response and Resilient Communities’ National Evaluation
OMB: 0920-1411
IC ID: 260599
OMB.report
HHS/CDC
OMB 0920-1411
ICR 202306-0920-005
IC 260599
( )
Documents and Forms
Document Name
Document Type
Community Health Workers CHW Survey
Form and Instruction
CHW Survey
Att 5 - CHW Survey English.pdf
Form and Instruction
Att 5a – CHW) Survey Spanish.pdf
CHW Survey (Spanish)
IC Document
Information Collection (IC) Details
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