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

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