Primary Health Care Digest Newsletter Subscriber Survey

Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration

OMB: 0915-0212

IC ID: 259876

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Primary Health Care Digest Newsletter Subscriber Survey
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Primary Health Care Digest Newsletter Subscriber Survey 03.31.2023-FINAL-CLEAN.docx Yes Yes Fillable Fileable

Health Health Care Services

 

5,000 0
   
State, Local, and Tribal Governments
 
   100 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 5,000 0 0 0 0 5,000
Annual IC Time Burden (Hours) 583 0 0 0 0 583
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
PHC Digest Newsletter Subscriber Survey Fast Track Memo - BPHC Digest Newsletter revised 4.27.23 .docx 04/27/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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