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Rural Health Network Development Planning Program Performance Improvement and Measurement System (PIMS) Form

IC 211181 under ICR 202604-0915-002 · OMB 0915-0384.

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Form and Instruction
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Rural Health Network Development Planning Program Performance Improvement and Measurement System (PIMS) Form
 
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 1 Rural Health Network Development Planning Program Performance Measures Proposed Measures - 0915-0384 - FORHP - Network Planning - Revision - 03092026.docx Yes Yes Fillable Fileable

Health Health Care Services

 

25 25
   
Private Sector Not-for-profit institutions
 
   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 25 0 2 0 0 23
Annual IC Time Burden (Hours) 281 0 258 0 0 23
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement FINAL - Revised Supporting Statement A Document Network Planning 03082023.docx 03/08/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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