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HRSA Web Survey
Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration
OMB: 0915-0212
IC ID: 261675
OMB.report
HHS/HSA
OMB 0915-0212
ICR 202401-0915-001
IC 261675
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0212 can be found here:
2024-01-10 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 1
HRSA Web Survey
Form
Form 1
HRSA Web Survey
Form
1 English Version_HRSA Web Survey
hrsa-approved-survey-questions-final_ENG.docx
Form
2 Spanish Version_HRSA Web Survey
hrsa-approved-survey-questions-final_ES.docx
Form
fast-track-hrsa-web-survey-20230817 Final.docx
HRSA Web Survey Memo
IC Document
Information Collection (IC) Details
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