OMB control number
Data Use Agreement and Supplement for 2014 Health Center Patient Survey
OMB 0906-0027 · HHS/HRSA.
OMB 0906-0027
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form 1 Data Use Agreement and Supplement for 2014 Health Center Patient Survey | Form and Instruction |
| DUA Supporting Statement A PASSBACK CLEAN 1-25-17.docx | Supporting Statement A |
 Data Use Agreement and Supplement for 2014 Health Center Patient Survey |
Form and Instruction |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 201610-0906-001 | New collection (Request for a new OMB Control Number) | 2016-10-24 | Approved with change |