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Federal forms, ICRs, and supporting documents

Information Collection

NHSC Comprehensive Behavioral Health Services Checklist

IC 225046 under ICR 202404-0915-002 · OMB 0915-0127.

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

View Information Collection (IC)

NHSC Comprehensive Behavioral Health Services Checklist
 
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 6 NHSC Comprehensive Behavioral Health Services Checklist NHSC Comp. BH Services Checklist.docx Yes Yes Fillable Fileable

Health Health Care Services

The Public Health Service and National Health Service Corps Health Care Provider Records System  86 FR 28362

4,400 0
   
Individuals or Households
 
   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 4,400 0 0 0 0 4,400
Annual IC Time Burden (Hours) 572 0 0 0 0 572
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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