Maternal, Infant, and Early Childhood Home Visiting Innovation Technical Assistant Center Satisfaction Surveys

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

OMB: 0906-0084

IC ID: 264348

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

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Maternal, Infant, and Early Childhood Home Visiting Innovation Technical Assistant Center Satisfaction Surveys
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 1 Annual Awardee Survey Instrument A_Annual Awardee Survey.docx Yes Yes Fillable Fileable
Form 2 Instrument B_Post Webinar Survey Instrument B_Post Webinar Survey.docx Yes Yes Fillable Fileable
Form and Instruction 3 Post Learning Collaborative Survey Instrument C_Post Learning Collaborative Survey.docx Yes Yes Fillable Fileable

Health Health Care Services

 

665 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 665 0 0 0 0 665
Annual IC Time Burden (Hours) 70 0 0 0 0 70
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Original Generic Request Fast track memo.ITAC Satisfaction Surveys.docx 01/09/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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