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BHW Performance Measures Forms

IC 206385 under ICR 202401-0915-003 · OMB 0915-0061.

Documents and Forms
Document Name
Document Type
Form and Instruction
Other-Program Mapping Document
Other-Program Mapping Document
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

BHW Performance Measures Forms
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Performance Metrics 2023.pdf 0915-0061 - Appendix C - Performance Metrics - 2023 (updated).pdf Yes Yes Fillable Fileable
Other-Program Mapping Document 0915-0061 - Appendix C - Program Mapping Document (updated).pdf Yes Yes Fillable Fileable

Health Public Health Monitoring

 

1,882 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Approved 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 1,882 0 252 0 0 1,630
Annual IC Time Burden (Hours) 5,929 0 527 0 0 5,402
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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