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Federal forms, ICRs, and supporting documents

Information Collection

National Hypertension Control Initiative (NHCI) Community Health Center Assessment

IC 263257 under ICR 202409-0990-001 · OMB 0990-0379.

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

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National Hypertension Control Initiative (NHCI) Community Health Center Assessment
 
Unchanged
 
Voluntary
 

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

Health Health Care Services

 

350 0
   
Individuals or Households
 
   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 350 0 0 0 0 350
Annual IC Time Burden (Hours) 175 0 0 0 0 175
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.