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Division of Independent Review Objective Review Assessment Survey
Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration
OMB: 0906-0084
IC ID: 264344
OMB.report
HHS/HRSA
OMB 0906-0084
ICR 202402-0906-004
IC 264344
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0906-0084 can be found here:
2024-06-28 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form 1.1
Division of Independent Review Objective Review Assessment Survey
Form and Instruction
1.1 Screenshot Reviewer Instr
DIR Review Assessment Survey form 1 - screenshot Reviewer instr.pdf
Form and Instruction
2 Form Chair Q 1-5
FORM CHAIR Q 1-5.pdf
Form
1 FORM Reviewer Evaluation Q 1- 15
FORM Reviewer Evaluation Q 1- 15.pdf
Form
1.2 FORM Reviewer Evaluation-Field Review Q 1 - 12
FORM Reviewer Evaluation-Field Review Q 1 - 12.pdf
Form and Instruction
Public Burden Statement Screenshot.pdf
Other-Public Burden Statement Screenshot
Supporting Statement A - DIR Review Assessment Surve.docx
Original Generic Request
IC Document
Information Collection (IC) Details
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