Information Collection Request

Bureau of Health Workforce Nurse Corps Supplemental Funding Evaluation

ICR 202309-0915-001 · OMB 0915-0393 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 5 INTRODUCTORY CALL SCRIPT FOR TELEPHONE ADMINISTRATION Form and Instruction New Available
Form 4 Outreach for Nurse Corps Evaluation: Participant and Alumni Survey Form and Instruction New Available
Form 3 Nurse Corps Evaluation: Participant and Alumni Survey Form and Instruction New Available
Form 3 Nurse Corps Evaluation: Participant and Alumni Survey Form and Instruction New Repair queued
Form 2 HRSA Nurse Corps Supplemental Funding Evaluation In-Depth Interview Recruitment and Scheduling Emails Form and Instruction New Available
Form 1 Nurse Corps Evaluation: In-Depth Interview Guide Form and Instruction New Available
Form 1 Nurse Corps Evaluation: In-Depth Interview Guide Form and Instruction New Available
NC Eval_Supporting Statement Part A_HHS_clean.docx Supporting Statement A Uploaded 2023-09-08 Available
Nurse Corps Supplemental Funding Supporting Statement B.docx Supporting Statement B Uploaded 2023-09-07 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
262067 Nurse Corps Evaluation: Participant and Alumni Survey Form and Instruction NewINTRODUCTORY CALL SCRIPT FOR TELEPHONE ADMINISTRATION
262067 Nurse Corps Evaluation: Participant and Alumni Survey Form and Instruction NewOutreach for Nurse Corps Evaluation: Participant and Alumni Survey
262067 Nurse Corps Evaluation: Participant and Alumni Survey Form and Instruction NewNurse Corps Evaluation: Participant and Alumni Survey
262067 Nurse Corps Evaluation: Participant and Alumni Survey Form and Instruction New
262065 Nurse Corps Evaluation: In-Depth Interview Guide Form and Instruction NewHRSA Nurse Corps Supplemental Funding Evaluation In-Depth Interview Recruitment and Scheduling Emails
262065 Nurse Corps Evaluation: In-Depth Interview Guide Form and Instruction NewNurse Corps Evaluation: In-Depth Interview Guide
262065 Nurse Corps Evaluation: In-Depth Interview Guide Form and Instruction New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
09/30/2026 36 Months From Approved
7,359 0 0
3,110 0 0
0 0 0





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
Nurse Corps Evaluation: In-Depth Interview Guide 1, 2 ,  
Nurse Corps Evaluation: Participant and Alumni Survey 3, 4, 5 ,   ,  

table that charts list of burden
  Total Approved 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 7,359 0 0 7,359 0 0
Annual Time Burden (Hours) 3,110 0 0 3,110 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No