3: Service Delivery Data

Healthy Marriage and Responsible Fatherhood Performance Measures and Additional Data Collection

Attachment_G_Instrument_3_nFORM_ServiceReceipt_clean

3: Service Delivery Data

OMB: 0970-0566

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OMB No.: 0970–0566 nonsubstantive change request mathematica

nFORM 2.0 Screens to Collect Information

on Services Provided to Participants


Note: Screen shots include fictional names for illustrative purposes. OMB Control Number and Expiration Date appear on entry to nFORM system and individual surveys. The NonSubstantive Change Request only applies to the Paperwork Reduction Act statement that appears on the nFORM 2.0 Home page.


Shape1

Shape2

Will replace with [Current Point of Contact Name]





C1-C6. Client Level Data on Service Contacts, Referrals, Incentives, and Workshops

















C7/C12/C13. Add/Edit Client Service Contacts, Referrals, and Incentives






W1. Workshop List






W2. Add/Edit Workshop

W5. Add/Edit Workshop Session Series

W4/W8. Manage Session Series and Client Registration



W7/W9/C11. Manage Session Occurrences and Attendance








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