Family-to-Family Health Information Center (F2F HIC) Feedback Surveys

OMB 0906-0040

The surveys will provide mechanisms to capture consistent, performance data; provide data to support the HHS Secretary's priorities of engagement; and allow HRSA to determine the extent to which F2F HICs provide service. F2F HICs can also use the data to evaluate the effectiveness of their interventions and improve services. Respondents are family members of children with special health care needs and professionals who serve such families.

The latest form for Family-to-Family Health Information Center (F2F HIC) Feedback Surveys expires 2022-03-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form 2 Family-to-Family Health Information Center Feedback Surveys Form and Instruction
Form 1 Family-to-Family Health Information Centers Data Submission Form Form and Instruction
FeedbackSurvey_GrantRecipient_Instructions Final clean.docx Supplementary Document
Attachment - F2F 60 Day FRN.pdf Supplementary Document
Supporting Statement B Final.docx Supporting Statement B
Supporting Statement A Final.docx Supporting Statement A
Family-to-Family Health Information Center Feedback Surveys Form and Instruction
Family-to-Family Health Information Centers Data Submission Form Form and Instruction

All Historical Document Collections

202201-0906-001 Approved with change	Extension without change of a currently approved collection	2022-01-18
201910-0906-002 Approved without change	No material or nonsubstantive change to a currently approved collection	2019-10-10
201812-0906-001 Approved with change	New collection (Request for a new OMB Control Number)	2018-12-10

OMB Details

Family-to-Family Health Information Centers Data Submission Form

Federal Enterprise Architecture: Health - Public Health Monitoring

Form 1

F2F HIC DataSubmission_Form.docx

Fillable Fileable

Form and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.