Information Collection

National Hypertension Control Initiative (NHCI) Community Health Center Assessment

IC 263257 under ICR 202406-0990-001 · OMB 0990-0379.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0379 can be found here:

Documents and Forms

Document Name Document Type
Form 1 National Hypertension Control Initiative (NHCI) Community Health Center Assessment Form and Instruction
1 National Hypertension Control Initiative (NHCI) Communit 0990-0379 BPHC card sort test script.docx Form and Instruction
1 National Hypertension Control Initiative (NHCI) Communit 0990-0379 BPHC card sort test script.docx Form and Instruction
0990-0379 NHCI Health Center Assessment Memo-correct.docx Fast Track Memo IC Document
0990-0379 NHCI Health Center Assessment Memo-correct.docx Fast Track Memo IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	National Hypertension Control Initiative (NHCI) Community Health Center Assessment	Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	National Hypertension Control Initiative (NHCI) Community Health Center Assessment	0990-0379 BPHC card sort test script.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 350	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	350	350
Annual IC Time Burden (Hours)	175	175
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Fast Track Memo	0990-0379 NHCI Health Center Assessment Memo-correct.docx	11/07/2023

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.